HomeMy WebLinkAbout2006 Summer Camp Permit - Permits - 12/5/2019 Champ Camp Policies and
Procedures
2006 Summer Camp
595 Chickering Rd
North Andover, MA 01845
(978) 683-8493
Health Care Policy
Health Care Consultant:
Dr. Barnett
122 Lancaster.
North Andover, MA 01845
(978) 686-2763
Health Care Supervisor
Tina V. Veth, R.N.
48 Highland Ave
Haverhill, MA 01830
(978) 372-1236
Emergency Phone Numbers:
All general emergencies - 911
Fire - 688-9590
Police - 683-3168
Ambulance - 911
Poison Control Center - 1-800-682-9211
Animal Control - 683-3168
Hospital utilized for emergencies:
Lawrence General Hospital
1 General St.
Lawrence, MA 01841
683-4000
OR
Holy Family
70 East St.
Methuen, MA 01844
(978) 687-0151
Emergency Procedures
In the event of an emergency, the following procedures will be
followed:
1 . Camp Director and Staff members will clear the area away from
the injured person.
2. Health Care Supervisor will assess the condition of the camper.
3. If a head or neck injury is suspected, care will be taken to not
move the camper.
4. Camp Director will get emergency medical help by calling 911 .
5. If camper is not breathing, Health Care Supervisor will begin CPR.
6. Camp Director will try every available contact number to reach the
camper's parent/guardian.
Procedures for Utilizing First Aid Equipment
1 . Location of First Aid Kit
The First Aid Kit will be located in the office.
2. Location of First Aid Manual
The First Aid Manual will also be kept in the office.
3. First Aid is administered by
All first aid will be administered by the Health Care Supervisor, Tina
Veth, R.N.
4. First Aid Kit is maintained by
The First Aid Kit will be maintained by the Camp Director, Brian Veth
5. Contents of First Aid Kit
The First Aid Kit will contain the following:
Band-Aids
Hydrogen Peroxide
Bacitracin
2X2's
Paper Tape
Ace Wraps
Emergency Ice Packs
Plan for Injury Prevention and Management
The gym will be inspected for hazards and dangerous or faulty
equipment each morning by the Camp Director prior to the campers
arrival. Faulty equipment will be repaired or replaced before campers
are allowed to use the equipment. If the faulty equipment cannot be
repaired or replaced, that piece of equipment will have a sign
prohibiting campers from using that equipment.
In addition to the daily inspection for hazards by the Camp Director,
staff members will visually check each piece of equipment to be used
by the campers throughout the day. Any hazards that are found will
be reported to, and handled by the Camp Director.
Procedures for Reporting Serious Injury, Hospitalization,
and Death of a Camper or Staff Member to Department of
Public Health
In the event of a serious injury, hospitalization or death of a camper
or staff member, the following procedures will be followed:
1 . Camp Director will follow the Emergency Procedures described
elsewhere in this Health Care Policy until the situation is resolved.
2. Camp Director will fill out an injury report form.
3. Camp Director make multiple copies of the injury report form and
mail one copy to the Department of Public Health.
4. Camp Director will keep one copy on file at the location of the
camp.
Procedure for Informing Parents When First Aid is
Administered to Their Child
All first aid administered will be recorded in ink in the medical log
book, to be kept in the office during the day.
At the time of pick up, the Camp Director will have the medical log
book to ensure that all parents are informed of the first aid
administered to their child that day. Parents will be asked to sign the
medical log book as acknowledgement of the fact they were informed
of the first aid administered to their child. The medical log book, as
well as all staff members will be available for parents who may want
more information on the first aid administered to their child that day.
Plan for Infection Control
TREAT ALL INCIDENTS AS IF THERE IS AN INFECTIOUS
DISEASE
Hand washing - Hand washing is the single most effective method in
stopping the transmission of contagious diseases.
Procedure for the Clean Up of Blood Spills
A Blood-Spill Kit will be kept in the office.
The Blood-Spill Kit will contain the following equipment:
Biohazard Red Bags
Disposable gloves
Paper Towels
Fresh Solution of Bleach (1 :10)
Bleach: Common household bleach will be diluted 1 :10 (1 part
bleach, 9 parts tap water)
Procedure:
1 . Take equipment to area of spill.
2. Put on disposable gloves.
3. Pour or spray disinfectant on area to be decontaminated.
4. Allow one minute.
5. Clean up with damp paper towels.
6. Repeat as necessary.
7. Place everything in Red Biohazard Bag.
8. Remove gloves in such a way as to prevent touching the exterior
of the gloves with your bare hands.
9. Discard the gloves into the Biohazard Bag.
10. Wash hands.
11 . Look at area to make sure it is clean.
Emergency Plan for Evacuation of Facility
1 . Evacuation Plans are posted next to each exit.
2. Staff members will lead campers out the safest exit and gather on
the side of the building.
3. The Camp Director will grab the attendance book and check for
any campers that may have been separated from the group.
4. The Camp Director will do a roll call to ensure all campers are safe
and accounted for.
5. Fire drills will be conducted on the first day of each camping week.
6. The Camp Director will keep records of each of the fire drills noting
the date, time and effectiveness of each fire drill.
Plan for Administering Medication
All medications will be kept in a locked safe in the office.
Medications prescribed for campers shall be kept in original
containers bearing the pharmacy label, showing the date of filling,
pharmacist's initials, serial number of the prescription, name of the
patient, name of the prescribing physician, name of prescribed
medication, directions for use, and if tablets or capsules, the number
in the container. All over the counter medications for campers shall
be kept in the original containers containing the original label, which
shall include directions for use.
Medication will only be administered by the parent in the presence of
the Health Care Supervisor.
Medication prescribed for campers brought from home shall only be
administered if it is from the original container, and there is a
parent/guardian to administer it.
Note: As camp is only 3 hours long, we request that parents
administer medications before or after camp. We request that
parents do not bring medication to the gym.
Plan for Returning or Destroying Unused Medication
When no longer needed, or at the end of the campers stay at the
camp, medications shall be returned to a parent/guardian whenever
possible. If the medication cannot be returned, it shall be destroyed
as follows:
Medication shall be destroyed by the Health Care Consultant,
witnessed by a second person and recorded in a log maintained by
the camp for this purpose. The log entry will include the following
information: the name of the camper, the name of the medication, the
quantity of medication destroyed, and the date and method of
destruction. The Health Care Consultant and the witness shall sign
each entry in the medication destruction log.
Note: As stated above, camp is only 3 hours long and medication is
not allowed at the camp.
Plan for the Care of Mildly III Campers
In the event that a camper becomes mildly ill, to the point that the
camper cannot participate in the program, the camper's
parent/guardian shall be notified. All available contact numbers shall
be tried in order to contact the parent/guardian. The parent/guardian
will be asked to bring the child home for the remainder of the day.
Procedures for Identifying and Protecting Campers with
Emergency Medical Information
In the case of a camper with emergency medical information, all staff
members will be made aware of all symptoms, and procedures to
follow in the event of any emergency for that camper.
Exclusion Policy for Serious Illnesses and Contagious
Diseases
Campers may be excluded from camp if any of the following criteria
are not met:
1 . A camper with an elevated temperature must return to a normal
body temperature for at least 24 hours before returning to camp.
2. A camper with a rash must have a note from a doctor regarding the
diagnosis and whether the rash is contagious or not.
3. A camper with head lice must be nit free before returning to camp.
4. A camper with a known medical condition which could affect their
level of consciousness; i.e., seizure disorders, CHD must have a
note from their doctor with medical clearance.
Questions concerning Meningococcal Disease
All staff members and all parents will receive the commonly asked
questions about Meningococcal disease sheet created by the
Massachusetts Department of Public Health.
Procedures for the Background Review of Staff
MGL c.105 CMR 430.090 Employment Background Information
(A) The operator shall develop and follow written procedures for the review of the
background of each staff person who may have unsupervised contact with a
camper.
The Camp Director will review all staff. This will include checking
former employers, contacting references, conducting a CORI and a
SORI check for each prospective staff member. The Camp Director
will require that all staff members be CPR and First-Aid certified. If
the prospective staff member meets all of the requirements above,
they will be given an interview for employment. All CORI reports will
be kept off site only accessible to the CORI authorized employee.
Employees that have been continuously employed at The Champion
Factory since their last CORI/SORI check, are exempt.
Contingency Plans
MGL c.105 CMR 430.211 Special Contingency Plans for Day Camps
Day camp operators, shall set forth procedures to be followed in dealing with the
following contingencies.-
(A) Children who are registered and on the camp roll but fail to arrive for a given
day's activities.
(8) Children who fail to arrive at the point of pickup following a given day's
activities.
(C) Children who appear at camp without having registered and without prior
notification.
(A) Camper who is registered and fails to arrive for the day's
activities:
—The Camp Director will double check the attendance and the
camper's registration form to ensure the camper should indeed be in
attendance.
Parents will be contacted using all available contact numbers.
(B) Camper who is missing from the point-of-pickup at the end of the
day:
Camp Director will double check attendance and roll call.
Camp Director will check the office to see if the camper was
picked up early.
—If these aren't successful, we will follow lost camper plan.
(C) Unregistered camper arriving at camp:
Staff will try to get child's parents if still on site. If the parent
has left or cannot be found, staff will try to identify who the child
arrived with.
Staff will call the child's parent if the phone number can be
obtained.
Disaster Plan
MGL c. 105 CMR 430.210(8) Disaster Plan
(8) Each camp shall have a written disaster plan at the campsite. All campers
and staff shall be advised of the procedures contained in the plan.
Arrangements for transporting individuals from the camp to emergency facilities
shall be included in the plan.
In the event of a natural disaster, the following steps will be taken:
1 . A whistle located at the Camp Director's desk will be blown to
notify all campers and staff of an emergency.
2. Staff will bring campers to the middle of the gym floor and the
Camp Director will do an attendance check to ensure all campers are
present.
3. Instructions will be given to staff members at this point.
Tornado
In the event of a tornado, the initial steps will be taken to ensure all
campers are present. Staff members will ask the campers to move to
the back corner of the gym while the Camp Director checks all doors
and windows.
Lightning
In the event of lightning, the initial steps will be taken to ensure that
all campers are inside the building and present. The phone will not
be used except in the event of an emergency.
Fire Evacuation Plan
MGL c. 105 CMR 430.210(A) Fire Drills
(A) Fire drills shall be held within the first 24 hours of the beginning of each
camping session. The fire evacuation plan shall be in writing and approved by
the local fire department. The plan shall indicate the frequency of fire drills to be
held during the camping season.
Fire drills will be conducted on the first day of each camping week.
The maximum number of students will be twelve. There will be three
staff.
There is an exit at each end of the gym. These exits will remain free
of obstructions.
A whistle that is kept at the Camp Director's desk will notify campers
and staff in the event of a fire.
The Fire Department will be called or in the case of an emergency
evacuation, the fire alarm (one at each door) will be pulled on the
way out.
The staff and campers will gather in the grassy area on the side of
the building. An attendance check will be conducted to ensure all
campers are present.
In the event of a fire the Camp Director will sound an alarm and alert
staff of the fire, the gym will be evacuated closing all doors. The Fire
Department will be contacted and given the following info:
Building name and address
Nearest cross street - Salem and Abbott
Location of the fire in the building
Any known info about the fire
Lost Camper Plan
MGL c. 105 CMR 430.210(C) Lost Camper Plan
(C) A written lost camper plan shall be formulated and kept on file. All staff shall
be trained in the procedures contained in these plans.
As soon as it is discovered that a camper is missing the staff will
report the following to the Camp Director:
Camper's name and age
Last place the camper was seen
What the camper was wearing
The staff will then conduct a search of the main gym and bathroom.
The Camp Director will gather the campers in the middle of the floor
and do an accurate head count.
One staff member will go out the front door, and one will go out the
back door in search of the missing camper.
The Camp Director shall check office records to determine if the
camper was picked up by parents or made other such arrangements.
If not, the parents will be contacted to determine if the camper was
picked up without notifying the office.
If not immediately found Police will be notified.
The search will continue until all campers are accounted for.
Protectinq Campers from the Sun
The Camp Director and all staff members will encourage the use of
sunscreen with a solar protection factor of 15 or greater. The Camp
Director and all staff members will also encourage the use of hats,
long sleeve shirts and pants should we decide to be in the sun for an
extended period of time.
Procedures for reporting suspected child abuse or
neglect
MGL c.105 CMR 430.093 Prevention of Abuse and Neglect
(A) The operator shall have procedures in place which protect campers from
abuse and neglect while in the camp's care and custody.
(B) The operator shall develop and follow written procedures for reporting of any
suspected incidents of child abuse and neglect in accordance with procedures
described in MGL c. 119 section 51A
In the event that a staff member suspects child abuse or neglect, the
Camp Director will be notified immediately. The Camp Director shall
contact the Massachusetts Department of Social Services. The
Camp Director shall contact the Board of Health if a 51A report is
filed. The Camp Director will assist in any way possible with an
official investigation.
Telephones Required
MGL c.105 CMR 430.209 Telephones Required
All day camps shall have immediate access to a telephone. The operator shall
maintain and post by each phone a current roster of telephone numbers of the
Health Care Consultant, and all police, EMS and Fire Departments serving the
camp.
Telephones are located at each end of the gym, providing immediate
access.
Egresses Required
MGL c.105 CMR 430.455 Egresses Required
All egresses shall be in compliance with the requirements of the State Building
Code
All egresses in the facility are in compliance with State Building
Code.
Traffic Control Plan
MGL c.105 CMR 430.210(D) Traffic Control
A written plan relating to the control of the movement of vehicular traffic through
the camp shall be on file.
Parents will be reminded to drop off and pick up in the rear of the
building where there is much less traffic. Parents are required to
walk their child into the building thus reducing the number of kids
alone in the parking lot. Parents are also reminded to come into the
building to pick up their child from camp.
Identification of Individuals on Premises - Intruders
The Champion Factory summer camp, "Champ Camp" has a policy
against any unregistered or unknown guests being present at the
facility. Unknown guests or intruders may pose a threat to the safety
of the campers, staff, or the camp itself.
1 . Staff is to report any unknown persons to the Camp Director
immediately.
2. Staff will be trained in this policy at the Staff Orientation meeting.
3. Campers will be instructed on the first day of camp on procedures
should they encounter an unknown guest or intruder during camp.
Animal Exposure
Because wild animals, including raccoons, bats and skunks, may
carry rabies, it is important that camps take precautions to minimize
encounters between campers and wild animals.
Camp staff will be informed about the risk of rabies associated with
exposure to wild or stray animals. Camp staff and all parents will
receive the Public Health Fact Sheet regarding rabies. Camp staff
and parents will also receive the Public Health Fact Sheet regarding
Lyme Disease.
Campers will be instructed on the proper procedures if they
encounter a wild or stray animal. Campers will also be instructed not
to handle dead, sick or injured wild animals. Animal control
(978) 683-3168 will be contacted in the case of any wild animal.
Champ Camp will do everything to not attract wild animals. No food
is stored on the property, and the dumpster lid is fastened tightly.
If contact occurs between a person and a stray animal, the wound or
area of skin will be washed immediately with soap and water for at
least 10 minutes. The health care provider and the North Andover
Board of Health will be contacted immediately to determine if the
person should be treated for rabies. Animal control will be contacted
to catch or find the animal that scratched or bit the person. The
animal control and Board of Health will assist with information about
submitting the animal to the MDPH Rabies Laboratory for rabies
testing.
STAFF ORIENTATION
Agenda:
1 . Discuss camp philosophy
2. Discuss health care policy
3. Discuss all policies and procedures
4. Discuss parents rights to request copies of background checks,
health care and discipline policies and procedures for filing
grievances.
5. Practice fire drill
6. Review CPR and First-Aid Procedures
7. Review and practice gymnastics spotting skills
8. Discuss Arts & Crafts projects for the summer
Camp Philosophy
To promote health and well-being through gymnastics in a safe, fun,
and engaging environment.
Gymnastics - Skills being taught as well as equipment will be age
appropriate. Skills should be at a level where children can succeed,
but still be challenged.
Arts & Crafts - Projects will be age-appropriate, to be completed with
care and safety. Every camper should get to bring something that he
or she is proud of at the end of the week.
Learning Activity - Activities shall be relevant to the world going on
around them. The general concept is more important than specifics,
as this is not school
Signed on this day of 14r) 26e&
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Owl., r
Dr. Barne t
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O O 0
Back Gym Area
Back door
Office
Bath Front Gym Area
Rooms
Half Wall
Waiting Area
Front door
Policy for Suspected Allergic Reactions
Campers with diagnosed potential life threatening allergic conditions (ie. bee stings,
peanuts,etc.):
• The Good Samaritan Law protects personnel in the administration of an Epi-Pen
from Liability.
• If a camper is deemed by a doctor to be at risk for possible anaphylaxis, the parent
or guardian must provide permission signed by both the child's doctor,and the
parent for the student to carry a prescribed Epi-Pen.
• An extra Epi-Pen must be provided for the nurse or camp counselor.
• Meeting is had with the parents prior to the child's attendance at camp to discuss
the camper's individual situation and to set up a plan to meet his/her needs.
• If epinephrine is administered,there will be immediate notification of the local
emergency services system (911), followed by notification of the parent or
guardian.
• Camper will be transported to nearest emergency facility by emergency services
personnel for evaluation and stabilization prior to being allowed back in the camp
setting. Written confirmation of this is to be brought to camp personnel.
In the event of suspected,unknown allergic reaction:
• Localized Reaction: Ice to be applied and parent notified.
• Systemic Reaction (difficulty breathing,tongue or throat swelling,facial
swelling,generalized hives, loss of consciousness): If weight less than 35 lbs,
EpiPen Junior 0.15mg; if weight greater than 35 lbs,EpiPen 0.3mg , if available;
and immediate activation of emergency services system(911) for immediate
assistance and transport of camper.
a
Brian Veth-Camp Director
Age-31
Certifications-CPR/First Aid
Tina Veth-Health Care Supervisor
Age-29
Certifications-Registered Nurse
Brittany Irwin-Junior Counselor
Age- 13
Certifications-CPR
Rose DiNuccio-Junior Counselor
Age- 14
Certifications-CPR
Olivia Foley-Junior Counselor
Age- 13
Certifications-CPR
FIRE DRILL CHECKLIST
Name of Building:
Building Address:
Name of Day Camp:
Drill Monitor. Title/Position
Fire Drill Location: Floor/Location to which occupants relocated:
Method of activation of fire alarm:
Time fire alarm activated: Time occupants vacated fire drill floor:
Floor Response Personnel
1. Evacuation Director present: No OK Unobserved
2. Assistant Evacuation Director(s)present: No OK Unobserved
3. Stair well monitors: No OK Unobserved
4. Elevator monitors: No OK Unobserved
5. Search monitors: No OK Unobserved
6. Assistants to the physically disabled and
non-ambulatory: No OK Unobserved
7. Interior doors closed but not locked
after searched. No OK Unobserved
8. Evacuation assistants checked rest rooms. No OK Unobserved
Over all response of floor response team. Satisfactory Unsatisfactory
Occupant Response
1. Occupant initial response on sounding of alarm. Satisfactory Unsatisfactory
2. Occupant noise level. Satisfactory Unsatisfactory
3. Occupants aware of location of stairwell. Yes No Unobserved
4. Did evacuation proceed in smooth and orderly manner? Yes No Unobserved
5. Did visitors to building participate in drill? Yes No Unobserved
6. Overall response of occupants. Satisfactory Unsatisfactory
Drill Monitor Signature:
Date of fire drill:
To: Camp Operators,Boards of Health
Fr: MA Department of Public Health,Division of Community Sanitation
Re: Recreational Camps for Children-Fire Prevention Inspection Checklist
Dt: February 2,2000
Note: This document includes a checklist to assist you in reviewing your camp to assess potential fire
hazards. Also included is a form that may be used in recording and documenting the history of all
required fire drills. This form may be duplicated for future use. Use of these documents does not
substitute for the fire department's inspection/written statement of compliance required by 430.215.
Fire Prevention Inspection Checklist
Housekeeping and Maintenance
1. ,No Smoking"signs posted. No Yes
2. "No Smoking"regulations observed. No Yes
3. Flammable liquid safely stored in approved containers away
from combustibles. No Yes
4. Trash/rubbish removal done on a regular basis. No Yes
5. All electrical plugs,switches and cords legal and in good repair. No Yes
6. Cords are not to be run across doorways or under carpets or mats
where they may be stepped on. No Yes
7. No extensive use of cords from outlets(octopus). No Yes
8. Heat-producing appliances well ventilated. No Yes
9. Electrical equipment turned off when not in use. No Yes
10. Malfunctioning electrical equipment immediately reported or taken
out of service. No Yes
11. Areas kept as clean and neat as possible. No Yes
12. Materials stacked so as not to tip or fall. No Yes
13. Corridors and doorways kept free and clear of obstructions. No Yes
Fire and Life Protection Systems
1. Adequate lighting in corridors,exits,and stairwells No Yes
2. Exit signs illuminate as required(all fights working). No Yes
3. Evacuation routes adequately posted. No Yes
4. Evacuation signs maintained-none defaced or missing. No Yes
5. Fire doors not wedged or blocked open,especially stairwells. No Yes
6. Stairwells free of obstacles, storage,debris,etc. No Yes
7. Corridors and exits unobstructed(no storage of files,furniture,etc.). No Yes
8. Stairwells,corridors,and exits free of trip and slip hazards. No Yes
9. Fire detection and alarm systems tested regularly. No Yes
10. Fire sprinkler connections and shut off valves visible and accessible. No Yes
11. Fire sprinkler heads clean and unobstructed. NO Yes
12. Adequate clearance(3 feet)for all fire extinguishers and hoses. No Yes
13. Fire equipment in proper locations and undamaged. No Yes
14. Fire evacuations director and assistant positions updated and fully
Staffed No Yes
15.All occupants instructed on evacuation plan. No Yes
CAMP LOCATION
INSPECTION DATE INSPECTED BY
OFFICIAL TITLE
PUBLIC HEALTH
Rabies
FACT SHEET
Massachusetts Department of Public Health, 305 South Street, Jamaica Plain, MA 02130
What is rabies?
Rabies is a disease of the brain and spinal cord and is caused by a virus. Rabies is a fatal disease. Rabies in
humans is very rare in the U.S., but rabies in certain animals—especially wildlife—is common in many parts
of the country, including Massachusetts.
How is rabies spread?
The rabies virus lives in the saliva(spit)and nervous tissues of infected animals and is spread when they bite
or scratch. The virus may also be spread if saliva from an infected animal touches broken skin, open wounds
or the lining of the mouth,nose, or eyes.In caves crowded with many bats, it may be possible to inhale the
virus floating on bat saliva in the air.
What kinds of animals spread rabies?
The rabies virus can infect any mammal(if it has hair or fur, it is a mammal), but is more common among
certain ones like bats, skunks, foxes,and raccoons. Cats, dogs,and livestock can also get rabies—and spread
it to their owners—if they do not have special shots to protect them. Rabies is very rare among small rodents
like squirrels, rats,mice, and chipmunks. Fish, reptiles(such as snakes,turtles and lizards), amphibians(such
as frogs and salamanders),and insects(bugs)cannot get or spread rabies.
How common is animal rabies in Massachusetts?
Hundreds of animals are found to have rabies each year in Massachusetts. Wild animals most commonly
found to be rabid include raccoons, skunks, bats,woodchucks and foxes. Over one hundred cats have tested
positive for rabies in Massachusetts.
How can you tell if an animal is rabid?
Rabid animals often behave strangely after the virus attacks their brains. Rabid animals may attack people or
other animals for no reason, or they may lose their fear of people and seem to be unnaturally friendly.Not all
rabid animals act in these ways, however, so you should avoid all wild animals—especially bats, skunks,
foxes, and raccoons. Also,you should not feed or touch stray cats and dogs.
What should you do if you think you've been exposed to rabies?
If you have been bitten or scratched by a stray or wild animal, or by a pet or farm animal that has been
behaving oddly, follow these steps:
l. Wash the wound with soap and water right away for at least ten minutes.
2. Call your health care provider and local board of health as soon as you finish washing. They will help you
decide if you need to be treated for rabies. It is important to follow their instructions exactly.
3. Contact your local animal control officer to catch or find the animal that scratched or bit you. Your local
board of health can tell you how to have it tested by the State Rabies Lab, if appropriate.
If your pet has been bitten or scratched by an animal that you think may be rabid, put on gloves before
touching your pet. Follow the steps above but call your pet's veterinarian instead of your own doctor as in
step 2.
What is the treatment for people exposed to rabies?
The treatment for people exposed to rabies involves two medications. One, called rabies immune globulin (or
RIG), contains antibodies to fight the virus and is given once. The other medication is rabies vaccine,which
ensures long-lasting protection,and is given as five shots over the course of a month. (Rabies shots are no
longer given in the stomach.)People who received the full series of rabies shots in the past need only two
rabies vaccine shots.To work best,the medications should begin as soon as possible after the bite or scratch.
However, if the animal has been caught and will be tested for rabies,you can wait for the test results to see if
the shots are necessary.
How can you prevent rabies?
• Avoid wild animals,especially bats, skunks, foxes, and raccoons. Do not feed or pet strays.Avoid any
animal—wild, farm or pet—that you do not know. Report any animal that behaves oddly to your local
animal control official.
• Teach your children to avoid wildlife, strays, and all other animals they do not know well.
• Do not handle dead, sick, or injured wild animals yourself; call the police or animal control officer. If you
must handle the animal, use heavy gloves, sticks or other tools to avoid direct contact.
• Make sure your pets are vaccinated against rabies and that their shots are up-to-date. By law, all dogs,
cats and ferrets must be vaccinated against rabies.
• Feed pets indoors and keep them indoors at night If they are outside during the day, keep them on a leash
or fenced in so they cannot wander. It is possible for vaccinated pets to get rabies. Pets allowed to roam
freely are more likely to get rabies and possibly expose people and other pets in your home.
• Fasten trash can lids tightly. Garbage attracts animals(like skunks,raccoons, and strays) looking for an
easy meal.
• It is against state law to keep wild animals such as skunks or raccoons as pets. There are no rabies
vaccines for most wild species.
• Cap your chimney with screens and block openings in attics, cellars, and porches to keep wild animals
like bats and raccoons out of your home.
• If you have bats in your house,talk to a professional about bat-proofing your home.
• Animal control officers, veterinarians,their assistants, and others who have a lot of contact with strays or
wildlife should get routine rabies vaccinations to protect themselves before they are exposed to the virus.
Where can you get more information?
• Your doctor, nurse or health center
• Your local board of health(listed in the phone book under local government)
• Massachusetts Department of Public Health, Division of Epidemiology and Immunization at(617) 983-
6800 or toll-free at 1-888-658-2850 or on the MDPH website at http://www.state.ma.us/dph/
Revised:March 2004
PUBLIC HEALTH Lyme Disease
FACT SHEET
Massachusetts Department of Public Health, 305 South Street, Jamaica Plain, MA 02130
What is Lyme disease?
Lyme disease is caused by bacteria that are spread by tiny infected ticks(in Massachusetts,by deer ticks). Both people
and animals can be infected with Lyme disease.
Where is Lyme disease found?
Lyme disease is most commonly found along the East Coast,the upper Midwest and the valleys of the far West_ In
Massachusetts,deer ticks are found everywhere,but especially in coastal areas,the islands and the Connecticut River
Valley. The disease is most likely to be spread between late May and early autumn,when ticks are most active.
How is Lyme disease spread?
Deer ticks cling to plants near the ground in brushy,wooded,or grassy places. The ticks,which cannot jump or fly,climb
onto animals and people who brush against the plants.Very young ticks,called larvae,which are no bigger than the period
at the end of a sentence,pick up the bacteria that cause Lyme disease by biting infected animals,such as field mice.
Slightly older ticks,called nymphs,which are the size of a poppy seed,are the stage most likely to bite and infect humans.
Adult deer ticks can also transmit the disease,.but they are not as great a risk as nymphs because the adults are less likely
to bite humans and they are easier to see and remove.
Ticks live for 2 years and can infect wild and domestic animals as well as people.Not all ticks carry Lyme disease,and
even being bitten by a deer tick does not mean that you will always get the disease.The tick must usually be attached for
at least 24 hours to pass on the bacteria,so removing the tick promptly will greatly decrease your chances of being
infected.
What are the symptoms of Lyme disease?
Early stage(days to weeks):An early symptom of Lyme disease is usually,but not always,a rash where the tick was
attached. The rash appears from 3 days to a month after the bite. It often starts as a small red area then spreads,clearing
up in the center so it looks like a donut.However,the rash may not always appear like this. Flu-like symptoms,such as
fever,headache,stiff neck,sore and aching muscles and joints,fatigue and swollen glands,are also common in the early
stages of Lyme disease.
These early symptoms often go away by themselves after a few weeks,but the person may remain infected.Without
medical treatment,about half the infected people will get the rash again in other places on their bodies,and many will
experience more serious problems.Early treatment with antibiotics clears up the rash within days and usually prevents
later problems.
Later stages(months to years): Three major organ systems—the joints,nervous system and heart—can be affected.
People with Lyme disease can develop late-stage symptoms even if they never had the donut-shaped rash.About 600%of
people with untreated Lyme disease get arthritis in their large joints,usually knees,elbows and wrists.The arthritis can
move from joint to joint and become chronic.About 10 to 20%of people who don't get treatment develop nervous system
problems. The most common problems include meningitis(an inflammation of the membranes covering the brain and
spinal cord),facial weakness (Bell's palsy)or other problems with nerves of the head,and weakness or pain(or both)in
the hands, arms,feet and/or legs. These symptoms can last for months,often shifting between mild and severe. The heart
beat also can be affected in Lyme disease,with slowing down of the heart rate and fainting. The effect on the heart can be
early or late.
How is Lyme disease diagnosed?
Lyme disease can be fairly easy to diagnose when someone gets the classic rash. It is much harder to diagnose without
the rash because its other symptoms resemble other diseases, like flu. To help diagnose these cases,doctors can have
patients' blood tested for antibodies to the Lyme disease bacteria.
How is Lyme disease treated?
Prompt treatment of early symptoms with certain antibiotics can prevent later,more serious problems. Treatment of
Lyme disease in its later stages has not been standardized.
How can you prevent Lyme disease?
• The only known way to get Lyme disease is from the bite of an infected deer tick. The best way to prevent Lyme
disease is to avoid areas where the deer ticks are likely to be found. If you live in or visit a high-risk area,you should
follow these precautions:
• Wear a long-sleeved shirt and long pants, and tuck your pant legs tightly into your socks. (Light colors will help you
spot the ticks on your clothes before they reach your skin.) Stay to the middle of paths.
• Use insect repellents that contain DEET on your clothes or exposed skin,or those that contain permethrin on your
clothes. Read labels carefully.Use products with no more than 10-15%DEET on children and no more than 30-
35%DEET on adults. Do not use insect repellents on infants. Wash skin thoroughly after returning indoors.Rare
but serious reactions to repellents can occur.
• Check for ticks every day. Their favorite places are on the legs,in the groin,in the armpits,along the hairline,and in
or behind the ears.The ricks are tiny,so look for new"freckles."
• Remove any ticks promptly using fine point tweezers.The tick should not be squeezed or twisted,grasp it close to
the skin and pull straight out with steady pressure.
• Know the symptoms of Lyme disease. If you have been someplace likely to have ticks between May and early
autumn and you develop Lyme disease symptoms,especially if you get a rash,see a doctor right away.
Is there a vaccine for Lyme disease?
LYMErixTM,a vaccine for Lyme disease approved in 1998 by the Food and Drug Administration(FDA),was removed
from the market by the manufacturer in February 2002. The company stated that sales of the vaccine were poor.There are
no other Lyme disease vaccines approved for use in humans.
Where can you get more information?
• Your doctor,nurse or clinic
• Your local board of health(listed in the phone book under local government)
• The Massachusetts Department of Public Health,Division of Epidemiology and Immunization at(617)983-6800 or
toll-free at 1-888-658-2850 or on the MDPH Website at http://www.state.ma.us/dph/
• Massachusetts Poison Control Center(concerning adverse reactions to insect repellents)(617)232-2120(Boston)or
1-800-682-9211 (other areas in Massachusetts)or 1-888-244-5313 (hearing impaired).
March 2002
.105 CNIR 430.153 APPENDIX 8
COMMONWEALTH OF MASSACHUSETTS
DEPARTMENT OF PUBLIC HEALTH
CAMPER INJURY REPORT
1. Today's Date 2. Camp Name 3. Address 4. Report ID Number
Heave hiank? 4-6
�. Age 6. Sex 7. Date of Accident 8. Time of Accident
1-0 2-o I I I I I
year. 13-14 15 day Mo. yr. 7-12 (24 hr.clock) 16-19
9. Briefly describe the accident and subsequent injury.
10. Location of the incident 11. What type of event 12. Activity at the time of the
causing the accident caused the injury? incident causing injury 25-26
23-24
GENTERAL(Check one) 20 01 ❑ Falling/StumbIing Supervised:
1 ❑ On the campgrounds
2 ❑ Off the campgrounds 02 ❑ Collision with person or 01 ❑ Arts and Crafts
object 02 ❑ Archery/Riflery
Specific(Check one) 21-22 03 ❑ Collision involving motor 03 ❑ Horseback Riding
01 ❑ Sleeping/Living quarters vehicle 04 ❑ Swimming
02 ❑ Kitchen/Dining area
04 ❑ Snuck by another person 05 ❑ Boating/Canoeing
03 ❑ Shower/Toilet 05 y
❑ Struck b missile 06 ❑ Hiking/Climbing
04 ❑ Other Building
06 El Drowning or near drowning 07 ❑ Competitive Sports/Games
05 ❑ Arts and Crafts area 07 ❑ Bite or Sting by animal,
Specify
06 ❑ Trail or Nature area insect or spider
07 ❑ Archery area
08 ❑ Bite or wound inflicted
08 ❑ Riflery area
by anima] 08 ❑ Other
09 ❑ Swimming area
09 ❑ Contact with excessive Specify
10 ❑ Boating area heat or flame
11 ❑ Horseback area
10 ❑ Using a tool(including a
12 ❑ Sport or Recreational cutting instrument)` unsupervised:
Field or Court09 ❑ Fitrhti
11 ❑ Friction na
13 ❑ Campfire/Cookout area 12 ❑ Contact with sharp object 10 ❑ Horseplay
14 ❑ Road/Highway other than tool 11 ❑ Walking/Running
15 ❑ General Campgrounds 13 El Other 12 ❑ Other
16 ❑ Primitive/Outpost Camp S eci'
Speciry P r7
17 ❑ Other
Jt;eC;i v
3. Did light or weather conditions contribute to the inJur,,?
N-MPH STATE L.4BOP.ATORY
S:=ND TO: DMSION OF CO;vIIvlJN-11-'SAN:t:,TIOX ❑ yes 2- ❑ No
305 SOUTH STREET
IAKAIC.4 PLAI1N, 1vLk 02130
Within SEVEN (7)days of occurrence
The Commonwealth of Massachusetts
Executive Office of Health and Human Services
Department of Public Health
Division of Community Sanitation
JANE SWIFT 305 South Street, Jamaica Plain, MA 02130-3597
GOVERNOR (617) 983-6761 (617) 983-6770 - Fax
WILLIAM D.01EARY
SECRETARY
HOWARD K. KOH,MD,MPH
COMMISSIONER
Choosing a Recreational Camp for Your Child
Questions and Answers For Parents
Attending camp should be a wonderful experience for your child. To help ensure this, it is
essential that a camp provide a safe and healthy environment for campers and staff. Please read
the following information. The Department of Public Health hopes that it will be useful in
making a decision about a camp for your child.
Q. What is a recreational camp for children?
A. It is a day or residential (overnight), sports,travel, or primitive program that offers
recreational activities and instruction to campers. A camp has five or more children and typically
runs anytime between June 1 and September 30 and during school vacations. Please note that
there are certain factors such as, length of time the camp runs and who operates a camp, that
influence whether or not a program is considered a camp. If you would like further details on
what a recreational camp is,please call your local board of health.
Q. Do recreational camps for children have to be licensed?
A. Yes. In Massachusetts, a camp must be inspected and licensed by the local board of health in
the city or town where the camp is located. In order to be licensed,the camp must meet
regulations developed by the Department of Public Health, and any additional local rules. The
regulations set up minimum standards for health and safety at a camp. Call the Board of Health
in the town where the camp is located to find out about the status of a camp's license and to
obtain a copy of the most recent inspection report.
Q. What does the board of health look for during an inspection?
A. Overall,the inspector will make sure that the camp provides an appropriate environment for
the well being of the campers. The inspector will look to see that the camp has, for example: safe
structures and equipment; adequate sanitary facilities, sufficient supervision of the campers;
appropriate plans in case of medical emergencies,natural and other physical disasters; sufficient
health care coverage; and injury and fire prevention plans. There are other policies and items that
must be checked by an inspector. Call your local board of health to find out what they are. Ask a
camp representative to let you see copies of any of the required plans and procedures.
Q. How do I know if the camp counselors are qualified?
A. All counselors are required to have at least four weeks experience in a supervisory role with
children or four weeks experience with group camping. Counselors must also complete an
orientation program before campers arrive at camp. Any counselor who supervises children in
activities such as horseback riding, hiking, swimming and other events must have appropriate
training, certification and experience in the activity. Ask to see proof that a counselor is certified
in a particular activity.
Q. Is the camp required to check the background of camp staff?
A. Yes. For any camp staff that may be alone with your child, the camp must look at the staff
person's background and qualifications to make sure the individual is appropriate to work with
children. To do this, the camp must look into the person's previous work history and confirm
three positive references. Also, camps are required to check the proposed staff person's criminal
history, if it is available,to ensure that s/he has not committed a crime that would keep the
individual from being a counselor. As a parent, it is important that you find out if the camp
reviews all of this information. To find out, ask the camp director and request a copy of the
camp's written policy on staff background checks.
Q.How old do camp counselors have to be?
A. There are different age requirements depending on the type of camp. A counselor working at
a residential (overnight), sports, travel,trip or special needs camp must be 18 years of age or
have graduated from high school. Counselors working at a day camp must be 16 years of age.
All counselors at all camps are required to be at least three years older than the campers they
supervise.
Q.Should the camp have a person on-site that knows first aid and CPR?
A. Yes. All camps are required to have an individual, called a health supervisor, at the camp at
all times who is at least 18 years of age and currently certified in first aid and CPR. The camp
must provide backup for the health care supervisor with a Massachusetts licensed physician,
physician assistant or nurse who serves as a health care consultant. Special needs camps and
residential camps where there is a large number of campers and staff,must have a licensed health
care provider, such as, a physician or nurse on-site.
Q. How will a camp be responsible for my child's medication?
A. The camp is required to keep all medications in their original containers and is required to
store all prescription medications in a locked cabinet. If your child will be participating in an off-
site field trip and will require prescription medication, an additional pharmacy container will
need to be provided. The only individuals authorized to give your child his/her medication is a
licensed health care professional or the camp health supervisor under the oversight of the camp
health care consultant; however,other arrangements may be made for emergency medications
such as for epi-pens and inhalers. When your child returns from camp,the medication must be
returned to the parent or guardian, if possible or, destroyed.
O: Can a came discipline my child?
A. Yes. A camp must have a written disciplinary policy that explains their methods of
appropriate discipline e.g. `Mime-out' from activities, sending a child to the Camp woes,
o A c c, cic:. Under no circumstance may a camper be punished by corporal punishment such.as
spanking,nor punished by denying food, or subjecting a camper to verbal abuse or humiliation.
Camp staff must be familiar with and follow the camp discipline policy.
Q. What action does a camp have to take to protect W child from abuse and neglect?
A. It is a requirement that all camps have procedures in place to protect campers from abuse and
neglect while at camp. Ask a camp representative for specific information on their prevention
L3 y, a as 1.7d! �£c^f 3? $;?_ La order w'fY�: to s3i#�.��`i's a;U 3.:3
NUMBER
COMMONWEALTH OF MASSACHUSETTS BHP-2006-0167
o' North Andover FEE
n Board of Health $50.00
•, il. DATE ISSUED
ti SsAkCMJ~ ^ t t` The Champion Factory July 05,2006
s
NAME
595 Chickering Rd. NORTH ANDOVER, MA 01845
ADDRESS
IS HEREBY GRANTED A Recreational Camp LICENSE
Recreational Camp
This permit is granted in conformity with the Statutes and ordinances relating thereto,and
expires August 26,2006 unless sooner suspe r revoked.
RESTRICTIONS: Day;9 a.m.-Noon;7/5/06-8/25/06
Board of
nn
Health
6L,
NOTES: Contact: Brian Veth;978.683.8493
f wog•., NUMBER
"o COMMONWEALTH OF MASSACHUSETTS BHP-2006-0167
—
o �7D North Andover FEE
Board of Health $50.00
DATE ISSUED
The Champion Factory July 05,2006
------ -----------------------------------------------------------------------------------
NAME
595 Chickering Rd. NORTH ANDOVER, MA 01845
------- ---
ADDRESS
IS HEREBY GRANTED A Recreational Camp LICENSE
Recreational Camp
This permit is granted in conformity with the Statutes and ordinances relating thereto, and
expires August 26,2006 unless sooner suspended or revoked.
RESTRICTIONS:Day; 9 a.m.-Noon; 7/5/06-8/25/06
Board of
- - Health
NOTES: Contact: Brian Veth;978.683.8493
Tewrr V North Andover '
Health Department Date:
Location:
(Indicate Address, if esi 1,or Name Business)
Check#: Aleo y
Type of Permit or License: (Circle)
r ➢ Animal
Dumpster
Food Service-Type:
Funeral Directors $
Massage Establishment
Massage Practice $
Offal(Septic)Hauler
Recreational Camp !�
SEPTIC PERMITS:
❑ Septic-Soil Testing
❑ Septic-Design Approval
❑ Septic Disposal Works Construction(DWC)$
❑ Septic Disposal Works Installers(DWI) $
Sun tanning
Swimming Pool
Tobacco
TrashlSolid Waste Hauler
Well Construction
t ➢ OTHER:(Indicate)
E
t
Health Agent Initials
i5`6
White-Applicant Yellow-Health Pink-Treasurer
APPLICATION FOR A LICENSE TO CONDUC A MAY 10 2006
RECREATIONAL CAMP FOR CHILDREN To�N of Nc�RTH AND OVER
HEALTH DEPARTMENT
Name of Camp: C \(a
Site Address: ss,5 C\�,\f k.Q,�Inc
Site Telephone: c - -f - (7-K y
Name of Camp Owner: �9 r \
Office Address: CA 5 Cti tC C,x%f
Telephone Number: C
Name of Camp Operator(if different):
Address:
Telephone Number:
Name of Health Care Consultant: o.< f
Address: o
Telephone Number: ro
Type of Camp: Day _ Residential
Hours of Operation: L am — -0 C) O 4"N
Dates of Operation: Opening:4jk� !S* ' Closing: ,> �'�J —�j y�
Swimming Pool: Yes Pool Permit Number No_� S
Bathing Beach: Yes No_
Meals Provided: Yes Food Permit Number No
Signature of Ap licant:
Official' Date: 3I Z t I o 6
See the next page for a list of documents that must be completed and submitted before your
application for a license can be fully processed. You are strongly encouraged to complete these
documents as soon as possible and submit them in advance. This will expedite the licensing
process.
n,
�J �r1�'�Ct.• C_ �����J v � l
yL4y
AJ30
W �-
/AJ
Camp Director
Name: V�
Age:
Coursework in camping administration:
Previous camp administration experience: , r_C Ca wj2 1-92 r-
If\ � o-&&Q c �Qs� S .
Health Care Consultant
+
Name: V t
Type of Medical License (must be a physician,nurse practitioner, or physician assistant
with pediatric training): r/ \l
MA License Number:
Health Supervisor
Name: M tl n: �e
Age: 210
Type of Medical License, Registration or Training(See 105 CMR 430.159(C):
Aquatics Director
Name: -XI'A
Age:
Lifeguard Certificate issued by:
Expiration date:
American Red Cross CPR Certificate:
Expiration date:
American First Aid Certificate:
Expiration date:
Previous aquatics supervisory experience:
Firearms Instructor
Name: 1W 1't
National Rifle Association Instructor's card(or equivalent):
Date certified: Expiration date:
Horseback Riding Instructor / /�
Name: /V /
License Number: Expiration date:
Stable
Location: v/ A
Licensed in accordance with MGL Ch.l 1 1 § 155, 158: Yes No
Attach the names, ages, applicable current certifications (if any), such as First Aid, and
the anticipated role at the camp of all supervisory staff(see below). Use as many pages
as necessary to complete this.
Supervisory staff means those persons with the responsibility, authority and training to
provide direct supervision to camper groups. This may include counselors,junior
counselors, general activity leaders or other staff who provide supervision to campers
without assistance.
Required Documents
See the MA Regulations for Minimum Standards for Recreational Camps for Children,
State Sanitary Code, Chapter IV - 105 CMR 430.000 and the guidance documents issued
by the Department of Public Health, Division of Community Sanitation for additional
assistance with developing the following documents.
■ Staff information forms (see attached)
■ Procedures for the background review of staff(105 CMR 430.090)
■ Copy of promotional literature (105 CMR 430.190(C))
■ Procedures for reporting suspected child abuse or neglect(105 CMR 430.093)
■ Health care policy (105 CMR 430.159(B))
■ Discipline policy(105 CMR 430.191)
■ Fire evacuation plan—approved by local fire department(105 CMR 430.210(A))
■ Disaster plan(105 CMR 430.210(B))
■ Lost camper plan (105 CMR 430.210(C))
■ Lost swimmer plan (105 CMR 430.210(C))
■ Traffic control plan(105 CMR 430.210(D))
■ Day Camps—contingency plan(105 CMR 430.211)
■ Primitive, Trip or Travel Camps—Written itinerary, including sources of emergency
care, and contingency plans (105 CMR 430.212)
■ Current certificate of occupancy from local building inspector(105 CMR 430.451)
■ Written statement of compliance from the local fire department(105 CMR 430.215)
■ If applying for initial license after January 1, 2000—lab analysis of private water
supply(if applicable)(105 CMR 430.300, .303)
Please note: If you are applying for an original camp license, that is, the original camp
license in each community where the camp is located, you must file a plan showing the
following with the board of health at least 90 days before your desired opening date (See
MGL Ch. 140 s. 32A):
■ Buildings, structures, fixtures and facilities
■ Proposed source of water supply
■ Works for disposal or sewage and waste water
rug
Ages 3 7
III 6 Gymnastics Lessons
Arts & Crafts Projects
C
Fun Games (( ;
Safe Learning Environment
i
Energetic Qualified Staff
Air-Conditioned Facility
Week 1: July 5th-7th (*$95)
Theme: America the Beautiful Champ Camp Prices
Week 2: July IOth- 14th p Mon-Fri 9:00 - 12:00 $150/wk
Theme: African Safari Week /" M-W-F 9:00 - 12:00 $95
Week 3: July 17th-21 st C, Daily 9:00 - 12:00 $35
Theme: Sports Week
Sibling and Multi-week discounts
Week 4: July 24th-July 28th
Theme: Space and Science Week
Week 5: July 31 st -August 4th `•�/
Theme: Circus Week
Week 6: August 7th-August 1 lth
Theme: It's A Bug's Life Gymnastics
Week 7: August 14th-August 18th 595 Chickering Rd-North Andover
Theme: Super Hero Week (978)683-8493
www.championfactory.com
Week 8: August 21 st -August 25th This camp is licensed by the North Andover Board of Health and complies with regulations of
Theme: Disney Week the Massachusetts Department of Public Health