Form Dcf F Cfs 52 PDF Details

The Department of Children and Families (DCF) in the State of Wisconsin places paramount importance on the safety and welfare of children under its purview. This commitment extends into all areas of its operation, including the transportation of children to and from various care facilities. A crucial part of ensuring this safety is the DCF-F (CFS-52) form, a Vehicle Safety Inspection form mandated by several chapters of DCF's regulations. This form, revised in December 2008, serves as a comprehensive checklist to assess the condition and safety of vehicles used in family child care, group child care, Residential Care Centers (RCC) for children and youth, day camps, and group foster homes. The form obligates licensees to undergo annual vehicle inspections performed by certified inspectors at garages, dealerships, or auto repair shops. These inspections cover a wide array of essential vehicle safety aspects, including brakes, suspension, safety features, steering, tires, exhaust system, and more. Failures to meet the stipulated requirements not only risk the issuance of a noncompliance statement but, more importantly, compromise the safety of child passengers. The stringent evaluation criteria demand attention to everything from brake lights and horn functionality to window integrity and door locks. After completion, the inspector's findings and recommendations on the form become a decisive resource for the Licensing Specialist's assessments and follow-up actions. Thus, the DCF-F (CFS-52) form embodies the state's dedication to maintaining high safety standards for child transportation, underscoring the importance of vehicle inspection in safeguarding Wisconsin's youngest residents during their commutes to child care and related activities.

QuestionAnswer
Form NameForm Dcf F Cfs 52
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesdcf_f_cfs52 dcf fcfs52 form

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DEPARTMENT OF CHILDREN AND FAMILIES

STATE OF WISCONSIN

Division of Early Care and Education

 

DCF-F (CFS-52) (R. 12/2008)

 

VEHICLE SAFETY INSPECTION

Use of form: Use of this form is mandatory to comply with DCF 52.47(6)(a)1., DCF 57.12(5), DCF 250.08(4)(b), DCF 251.08(7)(a), and DCF 252.09(3)(b). Failure to comply may result in issuance of a noncompliance statement.

Instructions: At 12-month intervals, the licensee shall provide this form to the garage, dealership or auto repair shop to be completed by the inspector upon completion of the vehicle inspection. The licensee shall submit the completed form to the Licensing Specialist.

Name – Facility

Type

 

 

 

 

 

 

 

 

Family Child Care

Group Child Care

RCC for Children and Youth

Day Camp

Group Foster Home

 

 

 

 

 

 

 

 

 

Vehicle – Year

Make

 

Model

 

Color

Odometer Reading

License Plate Number

 

 

 

 

 

 

 

 

 

Name – Inspecting Company or Agency

Name – Inspector

 

 

 

Telephone Number

 

 

 

 

 

 

 

 

 

Address

 

 

 

City

 

 

State

Zip Code

 

 

 

 

 

 

 

 

 

 

VEHICLE INSPECTION CHECKLIST

Item

Pass

Repair /

Item

 

 

Pass

Repair /

Replace

 

 

Replace

 

 

 

 

 

 

 

BRAKES

 

SAFETY FEATURES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.

Failure indicator light

 

17.

Turn signals operational

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

System integrity

 

18.

Head lights

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

Pedal reserve

 

19.

Tail lights

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.

Disc / drum condition

 

20.

Brake lights

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5.

Hoses and assembly

 

21.

Horn

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SUSPENSION

 

22.

Windows / Windshield (cracks / chips)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6.

Shock absorbers / struts

 

23.

Front seat safety belts condition

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7.

Springs

 

24.

Back seat safety belts condition

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8.

Shackles

 

25.

Door locks operational

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9.

Modifications

 

WIPERS / WIPER BLADES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STEERING

 

26.

Wipers operational

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10.

Lash

 

27.

Blades contact

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11.

Free turning

 

28.

Blades condition

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12.

Linkage play

 

TIRES – FRONT

Lft

 

Rt

Lft

Rt

 

 

 

 

 

 

 

 

 

 

13.

Power system

 

29.

Tread depth

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EXHAUST SYSTEM

 

30.

Matching

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14.

Leaks

 

31.

Condition

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15.

Legal muffler

 

TIRES – REAR

Lft

 

Rt

Lft

Rt

 

 

 

 

 

 

 

 

 

 

16.

Tailpipe

 

32.

Tread depth

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

33.

Matching

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

34.

Condition

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Brief Comments – Refer to Item Number

 

 

 

 

 

 

 

 

SIGNATURE – Inspector

Date – Inspection

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2. When this section is done, you have to include the necessary details in Hoses and assembly, SUSPENSION, Shock absorbers struts, Springs, Shackles, Modifications, STEERING, Lash, Free turning, Linkage play, Power system, EXHAUST SYSTEM, Leaks, Legal muffler, and Tailpipe so that you can move on further.

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