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HomeMy WebLinkAboutApplications - CertsDetails lnternal Only License Restriclions/Conditions Seating: 200 Expiration Date' 12t31t2026 Business lnformation Business Namet Camp Wingate*Kirkland Business Mailing Address (if different) Business E-Mail* heysandy@campwk.com Business Legal Entity Corporation Business Address in Yarmouth * 79 White Rock Road Business Phone #* 5083623798 Business Type* Food Service Corporation Name (if applicable) Wingate Kirkland Opearting LLC Tax lD (FEIN or SSN)* FEIN ls this a NAME CHANGE? No Owner / Manager lnformation Owner's Name' Sandy Rubenstein Manager/Contact Person Namet Will Rubenstein FEIN **-***3940 Owner's Phone Number 5083413799 Manager / Contact Person Phone Number* 5083413798 PLEASE LIST STAFF MEMBERS WHO HOLD THE FOLLOWING CERTIFICATIONS AND ATTACH COPIES OF CERTIFICATIONS Name of Certified Food Protection Manage(S) All food service establishments are required to have at least one (1) PERSON lN CHARGE on site during hours of operation Name and Title Tom Stark - Director Food Service Operations Address Telephone Number 5083623798 Email Emergency Telephone Number 5083413799 Please attach copies of certifications for all listed below: List all Certified Food Protection Managers* Tom Stark Sandy Rubenstein Daria Burrell lcilda Bell List all employees certified in Anti.Choke" Tom Stark Daria Bu rrell Sandy Rubenstein lcilda Bell List all employees with Allergen Certification' Tom Stark Sandy Rubenstein Daria Burrell lcilda Bell Establishment Operations Length of Permit Seasonal Seasonal To Date 11t01t2026 Number of Seats lnside* 150 You must call for an inspection three (3) days prior to opening. Establishment Type Continental Breakfast Common Victualler I Non.Profit Wholesale I Residential Kitchen for Retail Sale Food Service I I I Seasonal From Date o4to',U2026 Location is Permanent Structure? Yes Number of Seats Outside * 150 ft Total Seats Frozen Dessert 300 Retail Service Vending Food 0ther Name Change Only Affidavit New construction, remodel or conversion requires an Occupancy Permit from the Building Department in order to receive a valid Food Permit. I I I I Seasonal: You must call for an inspection three (3) days prior to opening. tr l, the undersigned, atlest to the accuracy of the information provided in this application and I affirm thal the food establishment operation will comply with '105 CMR 590.000 and all other applicable law. I have been instructed by the Board of Health on how to obtain copies of ,l05 CMR 590.000 and the Federal Food Code. Pursuant to MGL Ch. 62C, Sec. 49A, I certify under the penalties of perjury that l, to the best of my knowledge and belief, have filed all state tax returns and paid taxes required under lav/.* Sandra Rubenstein Dec '16, 2025 Worker's Compensation lnsurance Affidavit Type of Business. I am an employer with employees * Submitted by Staff I Business Other Other Business I do hereby certify, under the pains and penalties of perlury, that the information provided above is true and correct.'summer camp Sandra Rubenstein Dec 16,2025 lnsurance Policy lnformation Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of lnvestigations of the DIA for insurance coverage verification. lnsurance Company Name PMA lnsurance Group Policy # or Self-ins Lic. # 2025010291401Y lnsurer's Address Expiration Date 02t01t2026 Food / Retail Service SEASONAL FOOD SERVICE OPENING: All food service establishments must be inspected by the Health Department prior to opening. Please contact the Health Department to schedule the inspection three (3) days prior to opening. CATERING POLICY: Anyone who caters within the Town of Yarmouth must notify the Yarmouth Health Department by filing the required Temporary Food Service Application form seventy-two (72) hours prior to the catered event. These forms can be obtained at the Health Department, or from the Town's website at www.yarmouth.ma.us under Health Department, Downloadable Forms. FROZEN DESSERTS: Frozen desserts must be tested by a State certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Department. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms have been met. OUTSIDE CAFES: Outside cafes (i.e., outdoor seating with server service), must have prior approval from the Board of Health. OUTDOOR COOKING: Outdoor cooking, preparation, or display of any food product by a retail or food service establishment is prohibited. lacknowledge that lhave read and understand the information above.' Notice PERIVITS RUN ANNUALLY FROM JANUARY 1 TO DECEMBER 31. IT IS YOUR RESPONSIBILIry TO COMPLETE THIS APPLICATION EACH YEAR. ALL RENOVATTONS TO ANY FOOD ESTABLTSHMENT (pAtNTtNG, NEW EQUtpMENT, ETC.) MUST BE REPORTED TO AND APPROVED BY THE BOARD OF HEALTH PRIOR TO COMMENCEMENT. RENOVATIONS MAY REQUIRE MA ENGINEER SITE PLAN. I cAirp KIBKLANtlI @?.d 105 CMR 43O.O9O BACKGROUND INFORMATION Camp Wingate*Kirkland requires that every staff person and volunteer shall have a background free of conduct that bears adversely upon his or her ability to provide for the safety and well-being of the campers. Camp Wingate-Kirkland reserve the right to determine whether each staff person's and volunteer's conduct, criminal or otherwise, shall disqualify that person from employment or service at Camp. ln making this determination, the operator shall consider at a minimum the following inlormation be required: Application and Screening Processes for All New Staff Each job candidate fills out a Staff Application. The application includes requests for the following information: Prior work history, including name, address and phone number of a contact person at each place of employment for the previous five years Three positive reference checks from individuals not related to the staff person including, but not limited to, previous employers or school administrators. Training or certifications pertinent to camp Attached to the application are the following forms: COBI Request Form (Commonwealth of Massachusetts criminal record check) SORI Request Form (Sexual Offender Registry Information) ACA Voluntary Disclosure Statement (FM 16) ln accordance with M.G.L. c.6, $ 172G, Camp Wingate"Kirkland shall obtain an expanded CORI/ Juvenile Report from the Department of Criminal Justice lnformation Services for every prospective employees. For prospective employees who are not permanent Massachusetts residents, criminal background checks are conducted in their home and school states through a private company called National Background lnvestigators. Prospective employees coming from other countries are required to provide state criminal inlormation from the local chief of police, or other local authority with access to relevant information. Massachusetts SORI checks are conducted on everybody who has ever lived, worked in, or visited the United States. For candidates who live or attend school in states outside Massachusetts, we do whatever is required by the home state lo check his/her name against its Sexual Offender Registry Board database. With the exception of a lew overseas candidates, each prospective counselor is interviewed face-to- face. lf face{o-face interviews are not possible, the candidate will have an extended phone interview with one of the camp directors. ln either case, references are always called and notes are taken to be kept in the staff member's file. The international staff placement agency that we work with (CCUSA and lnterexchange) conducts background checks on all of the counselors that they place. WIN CATE No person shall be employed or allowed to volunteer at Camp Wingate'Kirkland until the Camp is in receipt of, reviews and makes a determination with regard to all background information required pursuant to 105 CMR 430.090.(c) and (d). Policies lor Returning Staff lf there is no interruption in the statf person's employment by the camp or organization operating the camp lrom the time of the initial background check, a new criminal or sex offender history is required at a minimum every three years. This applies only to permanent employees of the same camp or organization operating the camp. All retulning, seasonal staff members are required to complete new CORI and SORI Request Forms and Voluntary Disclosure Statements. The above background check procedures also apply to returning staff members. Performance evaluations from past summers are also kept in each staff member's file. 11 counselors spend any summers away from camp, additional references are checked prior to their return. 105 CMR 430.091 STAFF ORIENTATION Camp Wingate"Kirkland provides an eight day orientation and training, "Staff Week" for all counselors, junior counselors, and other applicable camp stafl and volunteers. Statf Week Camp Wingate-Kirkland is intended to educate employees about Camp Wingate.Kirkland's policies and procedures. Training includes all necessary instruction specific to overseeing certain camp activities or any specialized training to meet the needs of campers with unique physical or behavioral needs, as applicable- With the assistance of Yarmouth Police and Fire Department, statf participate training specific to disaster and emergency plans. A supervising member of the Health Center Staff instructs the stafl regarding health care policies at Camp Wingate'Kirkland.As part of the orientation, all counselors, junior counselors, and other staff and volunteers shall complete the online head injury safety training program provided by the Centers lor Disease Control and Prevention's "Heads-Up" training. Attendance at Staff Training is required for all counselors and junior counselors, and is a condition of employment at Camp Wingate-Kirkland. Prospective camp counselors are not eligible for hiring if they can The operator shall not assign any person to be responsible for a group of children nor utilize any staff or volunteer to supervise others until such person has received the minimum orientation described in 105 CMR 430.091 . Documentation of specilic training components and attendance records for such trainings shall be maintained according to 105 CMR 430.145. All camp staff members receive training that is specific for his/her individual job responsibilities . Training includes clear expectations for acceptable job performance. This includes camp counselors (Overnight and Day), Dining Hall staff, Health Center statl and Maintenance staff. as0.093: ABUSE & NEGLECT PREVENTION POLICIES & PROCEDURES Camp Wingate*Kirkland's Abuse and Neglect Prevention Policy is intended to protect campers from both abuse and neglect while in the Camp's care and custody. L Purpose The purpose of this policy is to help Camp Wingate Kirkland provide a caring and secure environment for all of its campers and to help the camp reduce its legal risk and liability exposure, ll. Definition Child abuse refers to an act committed by a parent, caregiver or person in a position ol trust which is not accidental and which harms or threatens to harm a child's physical or mental health or welfare. lll. Types of Child Abuse. Physical Abuse:A physical injury threat of injury or creation of a real significant danger of substantial risk of dealh, disfigurement or impairment of bodily functions. Such injury or threat of inlury, regardless of intent, is inflicted or allowed to be inllicted by non-accidental means. Examples: asphyxiation; bone fracture; brain damage, skull fracture, subdural hematoma; burns, scalding;cuts, bruises, welts, abrasions; internal injuries, poisoning; sprains, dislocations; gunshot, stabbing wounds.. Physical Neglect: The failure to provide food, clothing, shelter, or supervision for a child if the child's health or safety is endangered. Physical neglect may include multiple occurrences or a one-time critical or severe evenl that results in a threat to health or safety, such as toddler left alone. Other types of neglect include abandonment, inadequate supervision, inadequate clothing, inadequate shelter, inadequate personal hygiene, inadequate food and malnutrition.. Sexual Abuse: lncludes any act defined in the code of Massachusetts which is committed, or allowed to be committed, upon a child be his/her parent or other persons responsible for the child's care. Examples of such abuse are: sexual exploitation, sexual molestation, intercourse/ sodomy and other sexual abuse.. Medical Neglect: Relusal or failure by caretaker to obtain and/or follow through with a complete regimen of medical or dental care for a condition, which if untreated, could result in illness or development delays.. Mental Abuse/Neglect: A pattern of acts or omissions by the caretaker which result in harms to a child's psychological or emotional health or development. lV. Reducing the Risk of Child Abuse ln an effort to create the safest possible environment within Camp Wingate.Kirkland, several abuse prevention measures will be utilized. These measures include provision for regular training on child abuse issues to staff members and standards for appropriate discipline.. Statf Training: Belore camp begins, all staff members will be required to read the camp's abuse policy and indicate that they have read and understand the policy and agree to abide by it. This is also reviewed in great detail during Staff Week.. Discipline: All statf members are trained in appropriate methods of camper discipline. No physical punishment or verbal abuse, e.g.,ridicule, are to be used at any time. Vl. Reporting Child Abuse Should there be allegations of child abuse at Camp Wingate Kirkland these procedures will be followed:. Treat any allegation of child abuse seriously. 105 CMR 430.191 DISCIPLINE POLICY: lmmediately notify the Camp Directors, who will report it to Department of Children & Families by completing a 5lA report and notifying the Department of Public Health in writing. lmmediately begin documenting all procedures observed in the handling the allegation. Do not confront the accused with allegation unless and until advised by the Camp Directors to do so. The accused will be temporarily relieved of all ol their camp duties and kept away from children until the investigation is concluded. Observe confidentiality for both the alleged victim and the accused until advised to the contrary by the Camp Directors. Vll. Policy Review The Child Abuse & Neglect Prevention Policy & Procedures of Camp Wingate-Kirkland are reviewed annually by the Camp Directors, with assistance lrom legal counsel and input from A.M. Skier our insurance agency. Camp Wingate"Kirkland enforces policies of discipline and guidance consistent with understanding of the individual needs and development of a child. The goal of the policy to is maximize the growth and development of the children and for protecting the group and individuals within Camp Wingate*Kirkland. l{ discipline issues or concerns arise, the Director will contact parents and discuss what steps need to be taken in order to rectify the situation. The Director, at her sole discretion, may withdraw any camper whose behavior violates the camp's rules of conduct, infringes and/or interferes with the safety or rights of others. This includes behavior that is disruptive, inappropriate, or unsafe for lhemselves or others, Refunds are not available for children removed from camp lor disciplinary reasons. Basic Principles . Our focus at Camp Wingate Kirkland is on teaching and positive encouragement rather than on punishment.. We strive to be a high quality statf providing a high quality experience.. lnstead of having many detailed rules, we always appeal to the community to respect each other.. The Ladder of Discipline is a lramework through which camper behavioral challenges are addressed. Counselor Guidelines Responding. Ask lor help unless you are confident that you are responding in an appropriate way. The single biggest mistake that counselors make is not ask for help with camper issues. The Lodge Leaders and Directors are always available and should be interrupted if they appear busy.. ln interactions with campers, counselors should strive to respond rather than react to children. Guidelines for Responding to Children . You are being entrusted to be a care{aker for children.. There is a clear power diflerence between you and the campers which should inform your actions.. You must be sexually appropriate with campers at all times-verbally, non-verbally and physically. Policy . Under no circumstances may a counselor hit or strike a child.. Counselors must not use abusive or derogatory language with campers.. Counselors may never touch a child against his or her will, unless there is a clear and present danger to the child.. A counselor may never touch a child if the child appears uncomlortable with the touch, whether that discomfort is expressed verbally or non-verbally.. Never louch a child in a place on his or her body that is normally covered by a bathing suit, unless for a clear medical necessity, and then only with supervision by another adult.. Hazing of campers by other campers or counselors is not permitted. . Campers will not be subjected in initiation rites that are abusive in any manner. Per the Prohibitions Stated in CMR 430.191b, Camp Wingate*Kirkland strongly enforces:. Corporal punishment, including speaking is prohibited.. No camper shall be subjected to cruel or severe punishment, verbal abuse or humiliation. No camper shall be denied lood, water or shelter.. No child shall be punished for soiling, wetting or not using the toilet. CAMP WING E*KIRKLA ND LADDER o F DISCIPLINE Step One:After a sign of disrespectful or inappropriate behavior, the counselor points it out to the camper and asks for a change in behavior as needed. lt is important to explain the reason to the camper and make sure the suggested change is a reasonable one. Step Two: lf the behavior continues, the counselor should remove the camper from the presence of others. Ask the camper the reason lor their unacceptable behavior and try to work together to create an appropriate alternative. Step Three: ll situation has still not resolved in an acceptable manner, the counselor should ask for help from a co-counselor or another counselor. With the camper, the counselor, and the new third counselor, review the situation that occurred. Let the camper know the reason for the meeting. lt is important that the camper knows that this meeting is very out of the ordinary. Campers most always know this. Try to come up with alternatives/solutions, without threatening. Step Four: lf disrespectful behavior continues in any way, the counselor next goes to a leader. The counselor, leader, and camper will then meet to discuss the situation. Once there is a meeting with a leader, Sandy and Will are informed and the parents are called. . Be aware ol sexual or sexualized behavior in campers. Be firm and non-shaming when responding to such behavior.. Be aware o1, and minimize, activities that tend to over stimulate campers such as tickling and pillow f ights.. Be conscious about your own stress level and take appropriate steps to respond.. lf you have any question aboul any behavior or suspected behavior of a camper, please ask for help.. Safe places to touch are the hands, shoulders and upper back. Step Five: lf the disrespectful behavior continues after meeting with a leader, the next step is for the counselor and camper to meet with Sandy and/or Will. Changes for the behavior will be clearly stated to insure complete understanding by the camper. Parents will be informed of this meeting. Step Six: lf the camper's behavior does not change significantly, there will be a second meeting with Sandy and/or Will and the camper will probably be sent home. Parents will be informed of this and a departure time will be established. 105 CMR 430.210 (A) FIRE EVACUATION PLAN &DRILLS Fire drills shall be held within the lirst 24 hours of the beginning of each session. Each residential building contains a fire evacuation plan noting emergency exits. The bunk unit reviews the evacuation plan for their specilic building and this is practiced with the first 24 hours of the session. Additionally, when we practice the Search & Rescue/Lost Swimmer drill within the first 48 hours of each camp session, it is communicated to the campers and staff that the same procedure applies to fires and other emergencies. 1. lf a fire occurs at Camp, we must gather and account for everyone in Camp.2. As soon as the fire is reported to the office, someone there should call 9-1-1 and report it. Give directions to 20 Linnell Lane and if needed, inlormation about the location and type of fire.3. The witness will report whether or not he/she knows if any campers or staff might be trapped in the area of the f ire. 4. Simultaneously, the nearest person should run to the Otfice to alert the statf there to begin our emergency procedure. At the Office, he/she should take the orange horn hanging on a hook to the left of the door. The person will take the horn and run around Camp and end up at the basketball court (or alternate location depending on the location of the fire). 5. Upon hearing the horn, all members ol the Camp community will gather at the basketball court, unless the location of the fire makes that impossible. The Frog Pond Field, Tennis Courts and Upper Soccer Fields are alternate locations. 6. As campers and staff arrive, bunk counselors will get their campers seated in a line and will quickly count the number of campers present from their bunk to determine if there are any campers missing. 7. Once everyone is accounted for, everyone should stay there until the fire fighting personnel tell us it is okay to leave. While the emergency procedure is happening, Sandy (or Will if Sandy is not available) will assign roles to the maintenance crew. He/she will use the office statf and Leaders, as needed. At least one person should go to the Camp entrance at Linnell Lane to help guide the fire trucks to the site of thefire. Others should be assigned to go to the fire location and do as much as possible, without risking his/her own safety. 105 CMR 430.210 (B) DISASTER EMER ENCY PLAN Natural Disasters (Flood, Lightning, Wildlire, Tornado, Hurricane, etc.) ln the event that we can predict the possibility of a natural disaster, Will and Sandy will assign a Leader to stay tuned to local media outlets. lf the community is advised by local authorities to evacuate the area, the Camp will do so immediately. When appropriate, the Camp will lollow its standard emergency procedure ol blowing the horns and having the enlire community gather at the basketball court. Otherwise, Leaders will be sent around Camp to give evacuation or other instructions 10 the entire community. In case of tornado or high winds:. Go to basement oI new bunks (Hilltop, Joel's Place, Cottage) or to Linnell Lane, as instructed.. Stay away from glass enclosed places or areas with wide-span rools, like the Leoj. Crouch down against the lloor and cover the back of your head & neck with your hands. lf no suitable slructure is nearby, lie flat in the nearest ditch or depression and use your hands to cover your head ln case of flash llooding:. Evacuate lowJying areas (watedront, Frog Pond, etc.) and go to higher ground (Hill Bunks, Upper Soccer Field, Office). Do not try to walk through water that is more than ankle deep. lf in a vehicle, do not drive through a flooded area , even if it looks shallow enough to cross ln case of lightning:. Go to safe shelter immediately. lf boating or swimming, get out of the water immediately and go to the Leoj. lf out of camp in a wooded area, seek shelter under a thick growth of relatively small trees. lf you leel your hair stand on end, squat down with your head between your knees. Avoid isolated trees or other tall objects, bodies of water, sheds or Jences. Once inside, avoid using a telephone or other electrical appliances - do not take a shower ln case of wildfire:. Listen to local radio or television stations for updated emergency information. Follow the instructions of local otficials. Wildfires can change direction and speed suddenly. Local otficials can advise you ol the safest escape route, which may be different than you expected.. lf you are trapped, crouch in the pond. You cannot outrun a fire.. Lie Jlat and cover your body with wet clothing or soil.. lt water is not around look for shelter in a cleared area or among a bed of rocks.. Breathe the air close to the ground through a wet cloth to avoid scorching lungs or inhaling smoke. 2. The Waterfront Director or the person in charge of the watertront shall tell the lookout person to get one of the two horns out of the boat shed and run the upper loop around camp. While running the upper loop the lookout should be blowing the horn. The upper loop consists of the camp road past Redwood, the Health Center, the Office, Lodge 1, the Dining Hall, Lodge 2, Lodge 3, Lodge 4, Lodge 7, Lodge 5, the mail shed, the frog pond field and back to the basketball court. A CIT/the lookout, or person designated by Waterfront Director goes immediately to the Office and gets the clipboard/Sign-Out book, and runs to the Basketball Court. After the runner finishes the upper loop, report back to the waterfront. 105 CMR 430.210 (C) LOST CAMPER & LOST SWTMMER PLAN 1. lf a buddy tag is left on the buddy board or if it is determined that there are a different number of tags on the board than campers in the water, the Waterfront Director or the person in charge at the waterfront will blow four short whistle blasts to signity that the water should be cleared. 3. A second person, preferably not an LGT, will be instructed at the same time to get the other horn from the boat shed and run the lower loop around camp. The lower loop consists ot Hilltop, Motel, Joel's Place, Cottage, Lodge 6, the art barn, Lodge 8, Lodge g, the tennis courts, the beach volleyball court, the softball field, the upper soccer field, the lower soccer field, the archery range, the Leoj, and the campfrre site. After the lower loop is run, the runner should report back to the waterf ront. 4. Upon hearing the horns, all members of the camp community will proceed as quickly as possible to the basketball court. One of the camp nurses will immediately bring the AED to the waterfront and assist as necessary. As they arrive, bunk counselors will get their campers seated in a line and will quickly count the number of campers present from their bunk to determine if all campers are present. Some bunks will have both/all counselors taking part in the search and rescue at the waterfront. A Leader or other available staff member will count the number of campers if all the bunk's counselors are not available. 6. The Assistant Director or a camp Leader will take a walkietalkie trom the office and any cell phone to the waterlront and be responsible for receiving messages from the basketball court and communicating them to the Waterfront Director, or the person in charge of the Search and Rescue procedures. 7. While this is taking place, all staff members who are LGT certified will immediately assemble at the waterfront to begin the Search and Rescue procedures. These procedures are to be led by the Waterfront Director or the person in charge of the waterlront. 8. Once the horn is blown and the waterfront is emptied, the Waterfront Director will assign the first LGT to check underneath the two tloating rafts in third crib. The next two LGTs are instructed to check underneath the docks. All remaining LGTs will line up at the first crib rope and wait for lurther instructions lrom the WSI in charge. Search and Rescue will start ditferently if the missing person was checked into 3d crib. During the entire Search and Rescue the Waterfront Director will have a rescue tube and be standing on the dock between second and third cribs. This is to ensure the maximum safety of the LGTs. 9. At the command of the waterfront director, the LGTs will begin walking through the water, (this will be different if searching for missing person checked into 3rd crib) constantly scanning the bottom. Once the waterfront director feels that they are deep enough, the LGTs will do surface dives to the bottom, swim three strokes, and return to the surface. They should be scanning the bottom the entire time. All lifeguards should come up with their hands above their heads. Once lhey have reached the surlace, they will stroke back to the shallowest person, and then take 2 additional strokes backwards. On the count of the waterrront director, the procedure will continue: a. All campers are accounled for at the basketball coufi; or b. A victim is discovered - at which point the leader, or the LGT who discovers the victim (if the LGT is not too tired), will attempt an American Red Cross rescue; orc. lt is determined that the camper missing at the basketball court is the same one who is missing at the waterfront. lJ this is the case, the Yarmouth Rescue Squad will be called 5. Will or Sandy will supervise the operation at the basketball court. He or she will take the clipboard and the walkie-talkie from the office and be responsible for communicating with the Leader at the waterfront. lt is EXTREMELY important that the waterfront personnel are notified IMMEDIATELY once everyone is accounted for, or it is determined which camper is missing. immediately by the Assistant Director or a camp Leader at the watertront, or if necessary by the office. d. ln the case of a potential neck and spinal iniury, the most qualified lifeguards will initiate the procedures outlined by the American Red Cross. lf the lifeguard feels any hesitation about securing the victim to the backboard, he or she should wait for the Yarmouth Rescue Squad to arrive. ln this scenario, the victim should remain immobilized in the water. e. Once everyone is accounted lor at the basketball court, the procedure will end and the waterfront director will debrief campers and counselors at the basketball court.f. This procedure will be revised, reviewed, and rehearsed at least once during statf orientation week, and twice during the summer. 105 CMR 430.210 (D) TRAFFTC CONTROL To ensure the safety of our campers and staff Camp Wingate"Kirkland is closed to vehicular traffic. The main gates at White Rock Road remains closed during operating hours (except Day Camp Drop Off & Pick Up). A saw horse is to remain in the road at the Dining Hall to eliminate any cars driving through Camp that enter through the service entrance. Employees and guests arriving at Camp Wingate-Kirkland are instructed to park in the parking lot and walk into Camp. There are two lots with ample parking and lots to accommodate all stafl and guests. Posted speed limit in Camp Wingate.Kirkland is 7 miles an hour. The only cars permitted in Camp are Camp Wingate-Kirkland vehicles and the Site Managers truck. Drivers will abide by the strictly enlorced speed limit. Day Camp Drop Off & Pick Up At "Drop Off" the Main Entrance gates will be opened at approximately 8:1SAM to allow Day Camp lamilies to line up for drop off. Parents and campers are to remain in their cars until 8:30. A Camp W.K staff person will greet the parent at the driver side, while a second Camp W-K staff person will assist the camper from exiting the car. At "Pick Up" the Main Entrance gates will be opened at approximately 3:50AM to allow Day Camp tamilies to line up for drop otf . Parents and campers are to remain in their cars until 4:00PM. A Camp W.K staff person will greet the parent at the driver side, while a second Camp W'K statl person will assist the camper to enter the car. Emergency Response Vehicles At the start of each season, letters are sent to the Yarmouth Police and Fire Departments with dates that Camp is in operation and specific instructions to exclusively use the Linnell Lane entrance when coming to Camp. Staff are trained to instruct dispatchers with the information when calling 9-1-1 . This policy is reviewed annually with the Yarmouth Police Department. Deliveries All deliveries are to be made to through the Camp Wingate-Kirkland Service Entrance located at 20 Linnell Lane. With the exception of the U.S. Postal Service, delivery trucks can go no further than the Dining Hall. Packages from postal carriers such as Fed Ex and UPS can be left at the message center and will be brought to the oflice by a Camp W"K employee. 105 CMR 430.211 SPECIAL CONTINGENCY PLANS FOR DAY CAMPS .211(A) REGISTER CAMPERS WHO FAIL TO ARRIVE The Day Camp Director or day camp staff member checking in campers will notify the Camp office after '15 minutes of the start of the Day Camp Day that a registered camper has failed to arrive. An office assistant in the Camp office will contact the Parenvcuardian via phone using the inlormation available on the Emergency Notification Card for that child. The Camp office will keep the Day Camp Director appraised of the information gleaned (i.e. camper delayed or sick). .211 (B) CAMPER FA|LS TO ARRTVE AT PO|NT OF P|CK Up Camp WingatetKirkland does not provide any transportation to and from Camp for Day campers. .211 (C) UNREGTSTERED CHTLD ARRTVES AT CAMp lf a child nol registered in the Day Camp program arrives, the Day Camp Staff will bring the child directly to the otfice. Otfice staff will call the ParenvGuardian who dropped off the child and arrangements will be made to register the child over the phone or to have the child picked up. The child will wait at the camp office until registered or picked up. 105 CMR 430-150 {E) UNREC GNIZED PERSONS AT CAMP Camp Wingate'Kirkland has devised this policy under the guidance and direction of the Yarmouth Police Department. The safety of campers and staff at Camp Wingate.Kirkland is our number one priority. Camp Wingate'Kirkland is a private site limited to campers, staff and invited guests. When children are on property, both Camp W"K and rental groups, the main gates at White Rock Road must remained closed at all times. A visit to Camp by an "invited guest" must be approved first by Sandy & Will Rubenstein prior to their arrival. lnvited guests are required to wear badges that can be seen by campers and staff that indicate they have permission to be on site. The following are steps that staff are instructed to take to approach the situation. If you see a person you do not recognize and they are not wearing an approved visitors badge, carefully approach them and say, "Are Sandy or Will expecting you?" Then politely introduce yourself and escort them to the otfice. 2. Alternatively of encounter someone who does not belong at Camp, you can kindly explain that this is a "private summer camp" and escort them to the nearest exit. 3. lf the person you encounter refuses to come the office or leave, find the nearest person to assist you with finding someone to radio the office or go to the office to get Sandy or Will. Do not leave this person unsupervised. lf necessary Sandy or Will will contact the Yarmouth Police Department lor their assistance. During Stafl Week the staff are trained specilically by the Yarmouth Police Department on how to handle guests or intruders that they might encounter at Camp. 1 This policy is reviewed annually with the Yarmouth Police Department. 105 CMR 430.159 (B)(2) HEALTH CARE POLICIES & PROCEDURES The health care administration of Camp Wingate-Kirkland will be under the direction of the Gonsulting Physicians: Bonnie Arzuaga, MD and Nathaniel Vasquez, MD. The Consulting Physicians are responsible for the development o{ Health Care policies and procedures, training ol the Health Center staff and developing standing orders to be lollowed by Health Center Staff. On a day to day basis the Health Center is supervised by the Lead Nurse, Melissa Delorey a licensed RN in the state of Massachusetts. The Health Center Staff is comprised of seven Registered Nurses and three assistants who will administer health care to all campers and staff within the camp community. There is an RN on duty at all times. One physician has office hours every day. RECORDS Documentalion on individual camper health issues/visits will be maintained in our CampMinder database which is password protected from all but the Health Center Staff and Camp Directors. All campers and staff are required to submit a Health History, Physicians Examination with lmmunizations and consent for treatment prior to the first day ol the camping season. All forms are managed digitally via CampMinder. ln the event of a power failure, a hard copy of each camper and staffs records are filed on a locked cabinet in the Health Center. All of the medical records are stored digitally through our CampMinder system. Hard copies are destroyed at the tend of each season. MEDICAL LOG BOOK The Medical Log is maintained by CampMinder. Health Center stafl will chart all treatments digilally via CampMinder. At the end of each work day, the evening nurse on duty will print two separate treatment logs, one lor campers and one for staff, and lile it sequentially in a medical log binder. The treatment log will contain the names of campers and staff with a statement of their chief complaint as stated to the nurse and the action taken by the nurse or physician. There will also be a separate log to record the daily distribution of medications for all campers and staff. At the end of each day the evening nurse will file the Medication Log in the appropriate binder sequentially. MEDICAL STORAGE All Health Center supplies and equipment will be stored in the Health Center. All medications, prescription and non-prescription, will be locked at all times in a clean, dry place. At the time of dispensing, a Camp Nurse will unlock the medication room and dispense medications. Every medication that is dispensed is logged in CampMinder according to instructions on the child's Health Examination Form. They can be dispensed only al the Health Center. All equipment and health supplies will be purchased by the Camp Nurse or the camp directors. They will be purchased lrom a well known mail order dealer or at a local pharmacy using a camp charge account. All prescriptions written by Camp Wingate'Kirkland consulting physicians or a physician at the Cape Cod Hospital will be filled at the same local pharmacy. All health supplies are subject to approval by the Consulting Physician. MEDICATION All medications, prescriptions and nonprescription, will be kept locked in the Health Center. Each medication brought to Camp by a camper and staff will be kept locked in the Health Center and its dispensation will be recorded in a medication log. A Camp Nurse will administer all medications.. ln the event a Camp Nurse is not available (Dr. visit, hospital visit, day off) the Nurse will delegate administration of all medications to the Camp Directors. The Camp Nurse will review the proper procedures with the Camp Directors. The Camp Nurse, Camp Directors, and Camp Leaders will discuss campers'needs for daily medications prior to the opening day of the camp season. All medications are sent home with the campers at the end of their session. HEALTH CARE PROVIDERS One of the Consulting Physicians will hold office hours every day to see campers and staff with acute medical needs. lf a Consulting Physician is not available, or the situation requires more emergent care The following Health Care providers will be involved in administering health care to the campers and staff ol Camp Wingale-Kirkland: Cape Cod Hospital, Hyannis, MA, 508-771-.1800 Cape Cod Healthcare Urgent Care 508-862-7900 Any instructions received from the physician to the nurse, will be charted in the child's log. Hard copy instructions received from Health Care providers will be filled with the camper or statf's Health Center record. EMERGENCIES All emergencies will be called into 911 . All emergency transportation will be coordinated through 911 at the time of the emergency. Town of Yarmouth Fire and Police Departments are notified at the start of each season with requesled directions for bringing emergency vehicles in to Camp. TRANSPORTAT!ON A Camp Nurse will accompany any campers and staff that need lo see a Health Care provider outside of Camp, They will travel in a designated Camp vehicle, STANDING ORDERS The Standing Orders are updated by the Consulting Physicians prior to Staff Orientation Week each Camp season. These orders are signed by the consulting, the Camp Director, and the lead Camp Nurse each season. FIRSTAID All first aid will be administered by the Camp Nurse and logged immediately in the appropriate health log. First aid will be administered in accordance with the Standing Orders ol the attending physician. ln the event the Camp Nurse is not present for non-emergency first aid, a first aid certified person will attend to the needs of the individual. This person will record his/her actions in the appropriate health log and report these actions to the Nurse upon her/his return to camp. All first aid procedures will be reviewed with certified first aid statl prior to the opening day of the camp season. First aid kits will be provided to the staff for all out-of-camp trips. All camp vehicles will have a first aid kit. Stafi will receive an orientation to the use of the first aid kit during staff orientation week. All out of camp activities- day trips and overnight trips- are required to include a First Aid Kit prepared by the Camp Nurse. Each first aid kit will have a copy ol the standing orders, emergency procedures, and accident report forms. Each first aid kit contains the following: Band-Aids, sterile pads, qtips, antiseptic towelettes, ice packs, ace bandage, bacrtracin ointment, adhesive tape, antacids, Benadryl, Sudafed, Tylenol, alcohol prep swabs, rescue face shield, after bite, and gloves. A minimum of one stafi person is to be trained by the staff nurse in First Aid basic procedures. lf a camper is in need ol medication during field trips, the nurse will package the individual's medication in first aid kit and instruct and delegate a staff member to administer it. FOOD SERVICE The Camp Nurse will be available for assistance in planning and assessing the health care needs of the kilchen facility and staff according to the rules and regulations ol the township. The Camp Director and Head Nurse wlll work closely with the Head Chef to address special dietary needs of campers. HEALTH CENTER The Health Center is located next door to the Camp Office. The Nurse will be available lor routine health procedures, exams, and the dispensing of medications during established Health Center office hours. The Health Center is also open immediately after evening activity for those campers and staff who need bedtime medication. Parents of campers who are seen by a physician at Camp or the Cape Cod Hospital Emergency Room will be notified after the doctor visit. All campers admitted to the Health Center lor an overnight stay will have their parents notified at staff 's earliest convenience. Campers becoming ill during the night will be accompanied to the Health Center by one ol their counselors or Lodge Leader. 10s cMR 430.102 (A) RESTpENTTAL CAMP DTRECTOR Sandy Rubenstein Owner & Director since 2004 Will Rubensteln Owner & Director since 2004 105 EMR 430.102 (B) DAY CAMP DIBECTOR Jared Curran 01l20l2OO2 2 years prior experience Assistant Day Camp Director 105 cMR 430.102 (C) DESTGNATEO SUBSTTTUTE Daria Bunell Assistant Director since 2014 10s cMR 430.101 (A) RESIDENTTAUDAY COUNSELOR RATTOS 1 counselor per 4 campers 7 years or above 1 counselor per 4 campers under 7 years 105 CMR 430.101 (B) PRIMITIVE/OUTPOST. TRAVEL, TRIP CAMPS Does not apply 105 CMR 430.101 (C) ALL CAMPS - CAMPERS WtrH DtSABtLtflES Does not apply 10s cMR 430.020.103 (A) - AQUATTCS DTRECTOR The Camp Wingate-Kirkland Watedront during the 2024 summer will be under the direction of Joshua Pate. Joshua is certified in Water Salety lnstruction, Lifeguard Guard and CPR. 105 CMR 430.1s9 [A) HEALTH CARE CONSULTANTS Dr. Bonnie Arzuaga MD #258069 Dr. Nataniel Vasquez MD #257994 105 CMR 430.159 (AX6) - WRITTEN OBDERS TO BE FOLLOWEp BY HCS Currently being updated by Health Care Consultants. Will be available for inspection in June rc5 .:n R 41n 16n lel irFDtetNF STr)CKFn IN THE HEALTH CENTER PER STANDING ORDERS Acetaminophen (Tylenol) Antidianheal (Maalox) Bismuth Subsalicylate (Pepto-Bismol products) Calamine Lotion Chlorpheniramine Maleate (Robitussin Cough & Allergy Syrup) Cough Drops (Generic) Diphenhydramine (Benadryl) Guaifenesin (Mucinex products; Robitussin Cough & Cold CF Liquid) lbuprofen (Advil) Loraladine (Claritin products) Acetaminophen is used for the relief of fever as well as aches and pains associated with many conditions. Relieves symptoms of excessive stomach acidity in patients with indigestion, heartburn, gastroesophageal reflux disease, or stomach or duodenal ulcers. Used to treat diarrhea and minor stomach problems, such as stomach inflammation. Used as an antipruritic (anti-itching agent) to treat mild pruritic conditions such as sunburn, eczema, rashes, poison ivy, chickenpox, insect bites and stings. Temporary relief ol sneezing, itchy, watery eyes, itchy nose or throat, and runny nose caused by hay fever (allergic rhinitis), or other respiratory allergies. Used to ease coughing or soothe a sore throat. Used for treating allergic reactions. Used for the treatment of cough associated with colds and minor upper respiratory tract infections. Used to treat headaches, muscle aches, backaches, dental pain, menstrual cramps, arthritis, or athletic injuries. This medication is also used to reduce fever and to relieve minor aches and pain due to the common cold or flu. Provides relief of seasonal allergy symptoms such as watery eyes, runny nose (rhinitis), itching eyes, and sneezing. lt is also used for hives. Used to treat itching, skin rash, oozing, or other irritation caused by insect bites or by coming into contact with poison ivy, poison oak, or poison sumac. Poison lvy Treatment (lvy-Dry) 10s cMR 430.020.103 (A) - LIFEGUARp All Camp W"K staff are certified in Lifeguarding during staff week. Pseudoephedrine Hydrochloride (Advil' Cold & Sinus products) Sunscreen Tolnaftate (Tinactine) Temporarily relieve symptoms of the common cold, sinusitis (swelling and pain in the sinuses), and flu, including stufly nose, fever, headache, and body aches and pains. Used to protect the skin lrom the UV rays of the sun. Used to treat skin inlections such as athlete's foot, jock itch, and ringworm inlectaons. Tolnaftate is also used, along with other antifungals, to treat infections of the nails, scalp, palms, and soles of the feet. ACORD ,- CERTIFICATE OF LIABILITY INSURANCE OATE (MI'/DD,YY) 4t9t202s THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERNFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFTCATE OF TNSURANCE OOES NOT CONSTTTUTE A CONTRACT BETWEEN THE tSSUtNG TNSURER(S), AUTHORTZEO REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: lf the certificate holder is an ADOITIONAL INSURED, the policy(ies) must have ADDITIONAI- lNSl.rRED provisions or be endorsed lf SUBROGAIIoN lS wAlvED, subiect to the tems and condilions of the policy, certain policies may require an endorsement. A statemenl on this certificate does nol conler rights to lhe certificale holder in lieu of such endorsement(s). i!ilIl"t Attrskier Asency, tnc. A. M. Skier Agency 209 Main Avenue Hawley, PA 1842E PHONE E.fAIL ADORESS: 570-226 -1'tOs570-2264571i 800-245-2666 ffi, ra amskier@amskier.com INSURER(S) AFFORDING COVERAGE TNSURERA K & K Insurance GrouP, tnc. NAIC # 23E50 INSURED COVERAGES Camp Wingate Karkland 79 White Rock Road Yarmouth Port, MA 02675 NSURER C CRC x coMMERCTAL GENERAT LIAEI!tTY A lcLAtMs MAoE X occuR_) GEN'L AGGREGA'TE LIMIT APPLIES PER x PoLrcY iSP; Loc AUTOMOBILE LIAEIIITY AUTOS SCHEDULEDAUTOS NON,OWNED AUTOS -f uManeLu rna-- occua C ElcEss LlaB cLAtMs-MAoE DEO REIENTION 3 Toa*a"-" "or"a**r,ouAl|D EXPLOYERS' LAaLITY A1P0003450395601 4A0004425003301 MKLV1EUL104824 2025010291401Y REVISION NUMBER: POLICY EFF POLICY EXP 11t112024 11/,t/2025 accREGATE TORY L MIIS oTB- ER 2t1t2025 2/1/2025 'L EACHAccroENr EACH OCCURRENCE DAMAGE TO RENTED PRFM SFS EA 2ri,o2s 2/1/2026 MEo ExP (Anvone pe6on) LIMITS PRODUCTS, COMP/OP AGG Corr.rBlNE0 SINGLE LIMIT BODTLY INURY (P6r p6rson) 21112025 21',v2026 Deductible: Comp.; Coll 1,000,000 ,l,000,000 PERSONAL ANO ADV INJURY GENERAL AGGREGATE CERTIFICATE NUMBER THIS IS TO CERTIFYTHAT THE POLICIES OF INSURANCE LISTEO BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATEO, NOTWITHSTA'{DII{G ANY REQUIREMENT, TERM OR CONOTTION OF ANY CONTRACIOR OTHER OOCUMENTWITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURAIICE AFFOROEO BYTHE POLICIES DESCRIBED HEREIiI IS SUBJECTTO ALL THE TERMS, EXCLUSIONS AIID COiIDMONS OF SUCH POLICIES. LIMIS SHOWN MAY HAVE BEEN REOUCEO BY PAID CLAIMS. INSR L'R TYPE OF INSURANCE GENERA! LABILITY ADOLSUBR POLICY NUUBER $ xl tr t $ $ $ t $ 3,000,000 1,000,000 trx frREo AUTOS x $ s 5 $ 1000; '1000 5,000,000 5,000.000 B AXY PROPRETOF,PARITiER/EXECUTW! f41 OfFICE/IIEIBEREXCLUOEO? N D€SCAPTON Of oPERATOiIS b.br E I D SEASE . EACH EMPLOYEE EL D]SEASE , POL CY LIMII 500,000 500,000 $ $ Ir 500,000 $ BODILY INU RY (P6r accldenl)$ DESCRIPTIOi OF OPERATIICNS/LOCATIONS/VEHILCES {Attach ACORD 101. Addlllongl R.m.rt. Sch.dul., It morc .p..e 13 cqulrcd) Confirmation of coverage. CERTIFICATE HOLDER CANCELLATION Camp Wingate Kirkland 79 White Rock Road Yarmouth Port, MA 02675 SHOUIDANYOFTHEABOVEOESCRIBEOPOLICIESBECAI{CEIIEOBEFOFE iHE E.XPIiIAiIOI{ DATE THEREOf, NOTICEW]II BE DELTVERED IN ACCOROAI'|CE WTTH THE POLICY PROVISIONS. AIfIHOREED REPRESENTATIVE6 HENRY M. SKIER Presldont o ,988.2010 ACORO CORPORATION. All rights ros6rv.d The ACORD name and logo ar. rogiste.Gd marks ofACORDACORD 2s (2016i03) rNsuRER B PMA Insurance GrouP OISURER O INSURER F 5,000 1,000,000 3,000,000