2.223.A.2 · The time a child arrives and leaves the center each day must be recorded. Staff members must complete written attendance verification periodically throughout the day, including during transitions.

Written attendance verification for transition from inside to outside was not completed and documented on the date of visit. Identified through staff statement that written attendance records are not being maintained. Correction: Immediately ensure staff complete written attendance verification during transitions and record of documented transitions is maintained with children's daily attendance records. Correct by 09/18/2024

Corrected Corrected by Sep 18, 2024

Category: recordkeeping. Marked corrected in the state record.

2.208.A.2 · The following records must be on file at the center: A list of current staff members, substitutes, and staffing patterns;

Identified facility does not maintain an accurate staffing pattern to verify what staff are with each group of children throughout the day and when breaks are taken. Correction: Immediately ensure an accurate staffing patterns is maintained and available for review at the center. Correct by 09/18/2024

Corrected Corrected by Sep 18, 2024

Category: recordkeeping. Marked corrected in the state record.

2.216.A.1 · An early childhood teacher, assigned responsibility for a single group of children and working under the supervision of a director, must be at least eighteen (18) years of age and meet at least one (1) of the following qualifications:

Teddy lacking documentation of Early Childhood Teacher (ECT) qualifications at the time of visit and asssigned as an ECT. Correction: Immediately ensure verification of qualifications is maintained in staff file. Submit verification of ECT qualifications for Teddy with written response. Correct by 09/18/2024

Corrected Corrected by Sep 18, 2024

Category: supervision. Marked corrected in the state record.

2.230.B · Indoor and outdoor equipment, materials, and furnishings must be sturdy, safe, and free of hazards.

Splintering wood benches on playground, small nail protruding near front bulletin board, and several ripped/torn nap mats without easily cleanable surface, posing potential safety hazards. Correction: Immediately ensure indoor and outdoor equipment materials, and furnishings must be sturdy, safe, and free of hazards. Correct by 09/18/2024

Corrected Corrected by Sep 18, 2024

Category: physical safety. Marked corrected in the state record.

2.120.I · Every five (5) years, all child abuse and neglect inquiry background checks must be renewed by resubmitting an inquiry form and current fee to the Department for processing. An updated clearance letter or verification of the submission of the inquiry form must be obtained before five (5) years from the date reflected on the current clearance letter.

Reviewed 2 staff files and identified Teddy lacking TRAILS clearance letter completed within the past 5 years. Correction: All individuals requiring a background check must review Navigating the Background Check Investigation Unit's (BIU) Webpage powerpoint. Submit verification that Teddy has reviewed the powerpoint within 24 hours. Submit documentation of TRAILS for Teddy with written response to the Specialist. Correct by 09/18/2024

Corrected Corrected by Sep 18, 2024

Category: background checks. Marked corrected in the state record.

2.209.A.1 · An admission record must be completed for each child prior to or at the time of the child's admission. This record must be updated annually and when changes occur. The admission record must include:The child's full name, birth date, current address, and date of enrollment;

Reviewed 2 child files and identified 1 child with an enrollment record that had not been updated within the FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ past year. Correction: Immediately ensure an admission record must be completed for each child prior to or at the time of the child's admission and must be updated annually and when changes occur. Correct by 09/18/2024

Corrected Corrected by Sep 18, 2024

Category: recordkeeping. Marked corrected in the state record.

2.209.A.7 · An admission record must be completed for each child prior to or at the time of the child's admission. This record must be updated annually and when changes occur. The admission record must include: A dated, written authorization for emergency medical care signed and updated annually by the parent(s)/guardian(s). The authorization must be notarized if required by the local hospital, clinic, or emergency health care facility;

Reviewed 2 child files and identified 1 child with an expired emergency medical release. Correction: Immediately ensure all children in care have a dated, written authorization for emergency medical care signed and updated annually by the parent(s)/guardian(s). Correct by 09/18/2024

Corrected Corrected by Sep 18, 2024

Category: health medication. Marked corrected in the state record.

2.217.A.9 · At least one (1) staff member with the current Department-approved medication administration training and delegation must be on duty at all times.

Crissy was the only individual with medication administration training at the time of visit and lacking dated annual delegation maintained in staff file. Correction: Immediately ensure there is at least one (1) staff member with the current Department-approved medication administration training and delegation must be on duty at all times. Correct by 09/18/2024

Corrected Corrected by Sep 18, 2024

Category: ratio. Marked corrected in the state record.

2.213.B · All staff must complete a Department-approved standard precautions training prior to working with FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ children. This training must be renewed annually and will be counted towards ongoing professional development.

Reviewed 2 staff files and identified both lacking verificaiton of annual exposure control plan review maintained with Standard Precautions training. Correction: Immediately ensure all staff must complete a Department-approved standard precautions training prior to working with children and renews annually, including exposure control plan review. Correct by 09/18/2024

Corrected Corrected by Sep 18, 2024

Category: recordkeeping. Marked corrected in the state record.

2.213.N · Within thirty (30) calendar days of employment and annually, all staff responsible for the collection, review, and maintenance of the child immunizations records must complete the Colorado Department of Public Health and Environment immunization course.

Crissy with expired immunization training and responsible for the collection, review, and maintenance of the child immunizations records. Correction: Ensure within thirty (30) calendar days of employment and annually, all staff responsible for the collection, review, and maintenance of the child immunizations records must complete the Colorado Department of Public Health and Environment immunization course. Correct by 10/18/2024

Corrected Corrected by Oct 18, 2024

Category: health medication. Marked corrected in the state record.

2.217.C.9 · All Department-approved child care health consultants must complete the Department-approved training about child abuse prevention, which includes common symptoms and signs of child abuse or neglect. This training must be completed within thirty (30) days of hire and renewed every three (3) years.

Reviewed CCHC file and identified mandated reporter training was expired. Correction: Ensure CCHC completes the Department-approved training about child abuse prevention, which includes common symptoms and signs of child abuse or neglect. This training must be completed within thirty (30) days of hire and renewed every three (3) years. Correct by 10/18/2024

Corrected Corrected by Oct 18, 2024

Category: health medication. Marked corrected in the state record.

2.226.C.1 · The center must notify the children's parents or guardians in advance of any field trip. The staff-child ratio found at rule section 2.217, must be maintained at all times. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________

Reviewed walking field trip permissions for children in care and identified they are lacking the specific location, date(s), and time(s) the walks will take place. Correction: Immediately ensure the center must notify the children's parents or guardians in advance of any field trip. Correct by 09/18/2024

Corrected Corrected by Sep 18, 2024

Category: ratio. Marked corrected in the state record.

2.206.B.18 · The written policies and procedures must be developed, implemented, and followed, and must include at a minimum the following information: The procedure for caring for children who arrive late to the center and their class/group is away from the center on a field trip or excursion;

Reviewed parent handbook and identified it lacking procedure for caring for children who arrive late to the center and their class/group is away from the center on a field trip or excursion. Correction: Ensure the written policies and procedures are updated to include the procedure for caring for children who arrive late to the center and their class/group is away from the center on a field trip or excursion. Submit updated parent handbook with written response. Correct by 10/18/2024

Corrected Corrected by Oct 18, 2024

Marked corrected in the state record.

2.206.B.13 · The written policies and procedures must be developed, implemented, and followed, and must include at a minimum the following information: The procedure for governing field trips, television and video viewing, and special activities, including staff responsibility for the supervision of children;

Reviewed parent handbook and identified it lacking procedure for governing field trips. Correction: Ensure the written policies and procedures are updated to include the procedure for governing field trips, including staff responsibility for the supervision of children and parent/guardian sign updated handbook acknowledgment. Submit updated parent handbook with written response. Correct by 10/18/2024

Corrected Corrected by Oct 18, 2024

Category: supervision. Marked corrected in the state record.

2.137.A · All child care providers must have a written plan for continuity of operations in the aftermath of an emergency or disaster. Components of the plan must include:

Reviewed emergency plan and identified it lacking plan for continuity of operations in the aftermath of an emergency or disaster. Correction: Immediately ensure all child care providers must have a written plan for continuity of operations in the

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

2.229.H · Sharp tools and instruments must be stored in areas inaccessible to children.

Metal rake in unlocked storage shed and accessible to children. Correction: Immediately ensure sharp tools and instruments are stored in areas inaccessible to children. Corrected at the time of visit. Shed was locked and made inaccessible to children. NO RESPONSE REQUIRED. Correct by 09/18/2024

Corrected Corrected by Sep 18, 2024

Marked corrected in the state record.

7.702.5.C.3 · For a child with special health care needs requiring intervention and/or medication, the center must obtain written instructions for providing services from the child's parent(s)/guardian(s), and the health care provider. If an existing individualized health care plan is provided for the child, it must be reviewed and followed by the center staff when caring for the child. If the child does not have an existing individualized health care plan, the individualized health care plan must be obtained by the child’s first day of care.

Medication indicated on individual health care plan for child in care and facility lacking medication available to staff if needed. Correction: Immediately ensure for a child with special health care needs requiring intervention and/or medication, the center must obtain written instructions for providing services from the child's parent(s)/guardian(s), and the health care provider. If an existing individualized health care plan is provided for the child, it must be reviewed and followed by the center staff when caring for the child. If the child does not have an existing individualized health care plan, the individualized health care plan must be obtained by the child’s first day of care. Document correction in written response. Correct by 10/10/2023

Corrected Corrected by Oct 10, 2023

Category: health medication. Marked corrected in the state record.

7.702.72.C.6 · All pieces of playground equipment must be designed to guard against entrapment and strangulation. Any openings in gross motor equipment above ground must be smaller than three and one half (3 ½) inches or greater than nine (9) inches to prevent entrapment.

Newly installed slide and platform with multiple gaps between 3.5"-9", posing potential entrapment hazards. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ Correction: Immediately make eqipment in accessible to children until all pieces of playground equipment are designed to guard against entrapment and strangulation. Any openings in gross motor equipment above ground must be smaller than three and one half (3 ½) inches or greater than nine (9) inches to prevent entrapment. Violation partly corrected at the time of visit. Staff requested children stop using the equipment at this time. Document correction in written response. Correct by 10/10/2023

Corrected Corrected by Oct 10, 2023

Category: physical safety. Marked corrected in the state record.

7.702.72.C.1.a · All climbing equipment eighteen (18) inches or higher must have resilient surfacing of at least six (6) inches in the use zone surrounding the equipment.

Climbing structure and slide with fall height over 18" with approximately 1-3" resilient material (pea gravel) in some areas of the 6' use zone surrounding the equipment. Correction: Immediately ensure all climbing equipment eighteen (18) inches or higher must have resilient surfacing of at least six (6) inches in the use zone surrounding the equipment. Document correction in written response. Correct by 10/10/2023

Corrected Corrected by Oct 10, 2023

Category: physical safety. Marked corrected in the state record.

7.702.62.A.2 · The time a child arrives and leaves the center each day must be recorded. Staff members must complete written attendance verification periodically throughout the day, including during transitions.

Identified through staff statement that there were 10 children in care but observed 11 children signed into the program. Correction: Immediately ensure attendance verification is completed periodically throughout the day. Document correction in written response. Correct by 10/10/2023

Corrected Corrected by Oct 10, 2023

Category: recordkeeping. Marked corrected in the state record.

7.702.51.B.10 · If a medication is out of date or left over, the parent(s)/guardian(s) is responsible for picking up the medication. If the parent(s)/guardian(s) do not respond, the center must dispose of the medications as required by the Colorado Department of Public Health and Environment.

Expired emergency medication for child who is no longer in care. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ Correction: Immediately ensure if a medication is out of date or left over, the parent(s)/guardian(s) are responsible for picking up the medication. If the parent(s)/guardian(s) do not respond, the center must dispose of the medications as required by the Colorado Department of Public Health and Environment. Document correction in written response. Correct by 10/10/2023

Corrected Corrected by Oct 10, 2023

Category: health medication. Marked corrected in the state record.

7.701.32.D.1.a · . For all individuals whose activities involve the care or supervision of children or who have unsupervised access to children, requests must be submitted and successfully completed prior to caring for children or allowing unsupervised access to children.

Reviewed 3 staff files and identified Flavia lacking verification of TRAILS clearance letter or verification it has been submitted. Correction: All individuals requiring a background check must review Navigating the Background Check Investigation Unit's (BIU) Webpage powerpoint. Submit verification that Flavia has reviewed the powerpoint within 24 hours. Submit documentation of TRAILS clearance letter for Flavia with written response to Specialist. Correct by 10/10/2023

Corrected Corrected by Oct 10, 2023

Category: supervision. Marked corrected in the state record.

7.701.32.J · . Every five (5) years, all child abuse and neglect inquiry background checks must be renewed by resubmitting an inquiry form and current fee to the State Department for processing. An updated clearance letter or verification of the submission of the inquiry form must be obtained before prior to the five (5) years from the date reflected on the current clearance letter.

Reviewed 3 staff files and identified Crissy lacking verification of TRAILS clearance letter completed within the past 5 years. Correction: All individuals requiring a background check must review Navigating the Background Check Investigation Unit's (BIU) Webpage powerpoint. Submit verification that Crissy has reviewed the powerpoint within 24 hours. Submit

Open Not marked corrected in the state record

Category: background checks. Open / not marked corrected.

7.701.33.J.1.a.b.c · The following background check requests must be submitted and successfully completed for each state an individual has resided in, in the past five years, prior to an individual caring for children or allowing the individual unsupervised access to children in child care centers (less than 24-hour care), school-aged child care facilities, family child care homes, and qualified exempt provider homes: a. State criminal history check b. State sex offender registry check c. State abuse and neglect registry check

Reviewed 3 staff files and identified Flavia lived outside of Colorado in the past 5 years and lacking verification of final out-of-state clearance letter. Correction: All individuals requiring a background check must review Navigating the Background Check Investigation Unit's (BIU) Webpage powerpoint. Submit verification that Flavia has reviewed the powerpoint within 24 hours. Submit documentation of out-of-state background check clearance letter for Flavia with written response to Specialist. Correct by 10/10/2023

Corrected Corrected by Oct 10, 2023

Category: supervision. Marked corrected in the state record.

7.702.34.A.7 · The admission record must include: A dated, written authorization for emergency medical care signed and updated annually by the parent(s)/guardian(s). The authorization must be notarized if required by the local hospital, clinic, or emergency health care facility.

Reviewed 2 child files and identified 1 lacking emergency medical authorization. Correction: Immediately ensure the admission record must include a dated, written authorization for emergency medical care signed and updated annually by the parent(s)/guardian(s). Document correction in written response. Correct by 10/10/2023

Corrected Corrected by Oct 10, 2023

Category: health medication. Marked corrected in the state record.

7.702.51.A.2.a · At the time of admission, the parent(s)/guardian(s) must provide for each child entering the center: Documentation of school-required immunization status or Certificate of Medical or Nonmedical Exemption, is FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ required by the Colorado Board of Health. Up-to-date school-required immunizations must be documented as specified on the Colorado Department of Public Health and Environment Certificate of Immunization or on an "approved alternate" Certificate of Immunization. Colorado law requires proof of immunization status or exemption be provided prior to or on the first day of admission.

Reviewed 2 child files and identified 1 child with a certificate of immunization on non-approved form. Correction: Immediately ensure documentation of school-required immunization status or Certificate of Medical or Nonmedical Exemption, is required by the Colorado Board of Health. Up-to-date school-required immunizations must be documented as specified on the Colorado Department of Public Health and Environment Certificate of Immunization or on an “approved alternate” Certificate of Immunization. Colorado law requires proof of immunization status or exemption be provided prior to or on the first day of admission. Document correction in written response. Correct by 10/10/2023

Corrected Corrected by Oct 10, 2023

Category: health medication. Marked corrected in the state record.