2.312.C · Prior to working with children, the primary provider, applicant 2, equally qualified providers, qualified substitutes, and all staff members must complete a Department-approved training in standard precautions that meets current occupational safety and health administration (OSHA) requirements prior to working with children. This training must be renewed annually.

Reviewed provider file and observed R. Gramm having an expired Standard Precautions training. Correction: Obtain current documentation Standard Precautions training, add to provider file and submit documentation of compliance with written response to licensing specialist. Correct by 07/01/2025

Corrected Corrected by Jul 1, 2025

Category: ratio. Marked corrected in the state record.

2.312.D.1 · Prior to working with children all staff members caring for children not required by rule to be certified in First Aid and CPR must complete the Department-approved basic First Aid and CPR module. This module must be renewed every two (2) years.

Reviewed provider file and observed R. Gramm having an expired CPR and First Aid Training. Correction: Obtain current documentation CPR and First Aid training, add to provider file and submit documentation of compliance with written response to licensing specialist. Correct by 07/01/2025

Corrected Corrected by Jul 1, 2025

Category: recordkeeping. Marked corrected in the state record.

2.312.E · Prior to working with children, the primary provider, applicant 2, equally qualified provider, and qualified substitutes must complete a Department approved course of training for medication administration. This course must be completed every three (3) years and can be applied towards ongoing annual training hours in the year that it is completed;

Reviewed provider file and observed R. Gramm having an expired Medication administration training. Correction: Obtain current documentation Medication administration training, add to provider file and submit documentation of compliance with written response to licensing specialist. Correct by 07/01/2025

Corrected Corrected by Jul 1, 2025

Category: ratio. Marked corrected in the state record.

2.312.G · Prior to working with children, if working with children less than three (3) years of age, the primary provider, applicant 2, the equally qualified provider, qualified substitutes, and all staff members must complete a department-approved prevention of shaken baby/abusive head trauma. This training must be renewed every two (2) years and can be applied towards ongoing annual training hours in the year that it is completed.

Reviewed provider file and observed R. Gramm having an expired Shaken baby/abusive head trauma training. Correction: Obtain current documentation Shaken baby/abusive head trauma training, add to provider file and submit documentation of compliance with written response to licensing specialist. Correct by 07/01/2025

Corrected Corrected by Jul 1, 2025

Category: recordkeeping. Marked corrected in the state record.

2.312.H · Prior to working with children the primary provider, applicant 2, the equally qualified provider, qualified substitutes, and all staff members must complete a Department approved training about child abuse prevention, including common symptoms and signs of child abuse how to report, where to report, and when to report suspected or known child abuse or neglect within thirty (30) calendar days of employment. This training must be renewed annually.

Reviewed provider file and observed R. Gramm having an expired Medication administration training. Correction: Obtain current documentation Child abuse prevention training, add to provider file and submit documentation of compliance with written response to licensing specialist. Correct by 07/01/2025

Corrected Corrected by Jul 1, 2025

Category: ratio. Marked corrected in the state record.

2.312.I · Prior to working with infants, the primary provider, applicant 2, the equally qualified provider, qualified substitutes, and all staff members must complete a Department-approved safe sleep training. This training must be renewed annually.

Reviewed provider file and observed R. Gramm having an expired Safe sleep training. Correction: Obtain current documentation Safe sleep training, add to provider file and submit documentation of compliance with written response to licensing specialist. Correct by 07/01/2025

Corrected Corrected by Jul 1, 2025

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

2.312.J · Within thirty (30) calendar days of caring for children the primary provider and all individuals responsible for the collection, review, and maintenance of the child immunization records must complete the Colorado Department of Public Health and Environment (CDPHE) immunization course. This training must be renewed annually.

Reviewed provider file and observed R. Gramm having an expired immunization training. Correction: Obtain current documentation Immunization training, add to provider file and submit documentation of compliance with written response to licensing specialist. Correct by 08/01/2025

Corrected Corrected by Aug 1, 2025

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

2.312.K · Within thirty (30) calendar days of caring for children the primary provider, applicant 2, the equally qualified provider, qualified substitutes, and all staff must complete a Department-approved training regarding playground safety for homes. This course is required once and will be counted towards ongoing training requirements;

Reviewed provider file and observed R. Gramm to be missing Playground safety for homes training. Correction: Obtain current documentation Playground safety for homes training, add to provider file and submit documentation of compliance with written response to licensing specialist. Correct by 08/01/2025

Corrected Corrected by Aug 1, 2025

Category: recordkeeping. Marked corrected in the state record.

2.312.M · Within ninety (90) calendar days of caring for children the primary provider, applicant 2, the equally qualified provider, qualified substitutes, and all staff must complete a Department-approved introduction to the early FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ intervention and preschool special education programs. This course is required once and will be counted towards ongoing training requirements;

Reviewed provider file and observed R. Gramm to be missing Introduction into the early intervention and special education training. Correction: Obtain current documentation Introduction into the early intervention and preschool education programs training, add to provider file and submit documentation of compliance with written response to licensing specialist. Correct by 08/01/2025

Corrected Corrected by Aug 1, 2025

Category: recordkeeping. Marked corrected in the state record.

2.312.P · Within ninety (90) calendar days of caring for children the primary provider, applicant 2, the equally qualified provider, qualified substitutes, and all staff must complete a Department- approved training regarding “Injury Prevention for Homes.” This course is required once and will count towards ongoing training requirements.

Reviewed provider file and observed R. Gramm to be missing Injury prevention for homes training. Correction: Obtain current documentation Injury prevention for homes training, add to provider file and submit documentation of compliance with written response to licensing specialist. Correct by 08/01/2025

Corrected Corrected by Aug 1, 2025

Category: recordkeeping. Marked corrected in the state record.

2.312.Q · Within ninety (90) calendar days of caring for children the primary provider, applicant 2, and the equally qualified provider must complete the Department-approved training “Working with an Early Childhood Mental Health Consultant.” This course is required once and will be counted toward ongoing professional development.

Reviewed provider file and observed R. Gramm to be missing Working with an Early Childhood Mental Health Consultant training. Correction: Obtain current documentation Working with an Early Childhood Mental Health Consultant training, add to provider file and submit documentation of compliance with written response to licensing specialist. Correct by 08/01/2025

Corrected Corrected by Aug 1, 2025

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

2.312.R.1 · The primary provider, applicant 2, equally qualified provider, qualified substitutes, and all staff members shall: Complete a minimum of fifteen (15) clock hours of ongoing professional development each year. At least three (3) of the fifteen (15) clock hours must be in social emotional development. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________

Reviewed provider file and observed R. Gramm to be missing 15 Hours of annual training. Correction: Obtain current documentation of 15 Hours of annual training, add to provider file and submit documentation of compliance with written response to licensing specialist. Correct by 08/01/2025

Corrected Corrected by Aug 1, 2025

Category: recordkeeping. Marked corrected in the state record.

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

Reviewed 5 children's files and observed 2 child files having expired emergency medical authorization. Correction: Obtain current emergency medical authorization, add to files. Correct by 07/01/2025

Corrected Corrected by Jul 1, 2025

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

2.321.A.4 · Statements of health status of children less than two (2) years of age must be updated as required in writing by the health care provider, or in accordance with the American Academy of Pediatrics Recommendations for Preventive Pediatric Health Care recommended schedule at https://downloads.aap.org/AAP/PDF/periodicity_schedule.pdf,(4th ed. American Academy of Pediatrics, 2017) herein incorporated by reference. No later editions or amendments are incorporated. These recommendations are available at no cost from https://www.aap.org/. These recommendations are also available for public inspection and copying at the Colorado Department of Early Childhood, 710 S. Ash St., Denver, CO 80246, during regular business hours..

Reviewed 5 child files and observed 1 child's file for a child less than 2 years of age to be missing a current Health status form. Correction: Obtain current documentation of current health status form, add to child's file. Correct by 08/01/2025

Corrected Corrected by Aug 1, 2025

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

2.336.C.1 · All hazardous items and materials must be inaccessible to children including, but not limited to, office supplies, matches, plastic bags, cleaning and laundry materials, perfumes, curling irons, adult sharp scissors and FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ knives, cosmetics, shaving lotions, hair products, poisonous plants, and all items labeled by manufacturer as “keep out of reach of children.”

Cleaning products and paint labeled keep out of reach of children, sharp tools accessible to children in unlocked garage, posing potential safety hazards. Correction: All hazardous items and materials must be inaccessible to children. ***CORRECTED AT TIME OF VISIT*** Provider locked garage, making items inaccessible to children. Correct by 07/01/2025

Corrected Corrected by Jul 1, 2025

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

2.336.C.2 · In rooms accessible to children, all electrical outlets and power strips must have protective covers, or safety outlets must be installed; all exposed light bulbs accessible to children in areas where children can play must have protective covers. Electrical cords must be in good condition and must not pose strangulation, falling, or tripping hazards.

3 electrical outlets to be missing protective covers accessible to children in play room. Correction: In rooms accessible to children, all electrical outlets and power strips must have protective covers or safety outlets must be installed. *** CORRECTED AT TIME OF VISIT*** Provider installed protective covers making them inaccessible to children. Correct by 07/01/2025

Corrected Corrected by Jul 1, 2025

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

2.337.A.7 · All outdoor areas where children may pass or play must be kept free of animal contamination. All animal wastes must be promptly removed and inaccessible to children.

Outdoor play area having multiple areas of animal contamination. Correction: All outdoor areas where children may pass or play must be kept free of animal contamination. All animal waste must be promptly removed and inaccessible to children. Submit plan of compliance with written response to specialist. Correct by 07/01/2025

Corrected Corrected by Jul 1, 2025

Marked corrected in the state record.

2.312.C · Prior to working with children, the primary provider, applicant 2, equally qualified providers, qualified substitutes, and all staff members must complete a Department-approved training in standard precautions that meets current occupational safety and health administration (OSHA) requirements prior to working with children. This training must be renewed annually.

Provider having an expired standard precautions training. Correction: Obtain documentation of current standard precautions training and add to file. Correct by 07/02/2024

Corrected Corrected by Jul 2, 2024

Category: ratio. Marked corrected in the state record.

2.312.J · Within thirty (30) calendar days of caring for children the primary provider and all individuals responsible for the collection, review, and maintenance of the child immunization records must complete the Colorado Department of Public Health and Environment (CDPHE) immunization course. This training must be renewed annually.

Provider having an expired immunization training. Correction: Obtain documentation of current immunization training and add to file. Correct by 07/02/2024

Corrected Corrected by Jul 2, 2024

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

2.312.D · Prior to working with children, the primary provider, applicant 2, equally qualified provider, and qualified substitutes must complete the a Department-approved First Aid and CPR training, for all ages of children from infant to twenty-one (21) years of age;

Provider having an expired cpr/ first aid training. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ Correction: Obtain documentation of current cpr/ first aid training and send verification to specialist with written response. Correct by 07/02/2024

Corrected Corrected by Jul 2, 2024

Category: recordkeeping. Marked corrected in the state record.

2.312.E · Prior to working with children, the primary provider, applicant 2, equally qualified provider, and qualified substitutes must complete a Department approved course of training for medication administration. This course must be completed every three (3) years and can be applied towards ongoing annual training hours in the year that it is completed;

Provider having an expired medication administration training. Correction: Obtain documentation of current medication administration training and send verification to specialist with written response. Correct by 07/02/2024

Corrected Corrected by Jul 2, 2024

Category: ratio. Marked corrected in the state record.

2.312.H · Prior to working with children the primary provider, applicant 2, the equally qualified provider, qualified substitutes, and all staff members must complete a Department approved training about child abuse prevention, including common symptoms and signs of child abuse how to report, where to report, and when to report suspected or known child abuse or neglect within thirty (30) calendar days of employment. This training must be renewed annually.

Provider having an expired child abuse prevention training. Correction: Obtain documentation of current child abuse prevention training and add to file. Correct by 07/02/2024

Corrected Corrected by Jul 2, 2024

Category: recordkeeping. Marked corrected in the state record.

2.312.I · Prior to working with infants, the primary provider, applicant 2, the equally qualified provider, qualified substitutes, and all staff members must complete a Department-approved safe sleep training. This training must be renewed annually. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________

Provider having an expired safe sleep training. Correction: Obtain documentation of current safe sleep training and add to file. Correct by 07/02/2024

Corrected Corrected by Jul 2, 2024

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

2.311.A.14 · Subsequent health evaluations for the primary provider, applicant 2, and children residing in the home who are less than ten (10) years of age must be obtained every two (2) years or as required in a written plan signed by a licensed physician or other health care provider. A new family member and/or a new resident of the home must obtain a health evaluation form signed and dated by a licensed physician or other health care provider within thirty (30) days from the date the individual began living in the home.

Provider having an expired health statement. Correction: Obtain documentation of current health statement and send verification to specialist with written response. Correct by 08/02/2024

Corrected Corrected by Aug 2, 2024

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

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

Reviewed 12 children's files and observed 5 files having an expired emergency medical authorization. Correction: Obtain documentation of current emergency medical authorization and add to file. Correct by 07/02/2024

Corrected Corrected by Jul 2, 2024

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

2.321.A.2.c · At the time of admission, the parent or guardian must provide the following information to the provider for each child entering the family child care home: Documentation of school-required immunization status or 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 (CDPHE) certificate of immunization or on an "approved alternate" certificate of immunization as described in CDPHE regulations at 6 CCR 1009-2:VI(A), (May 15, 2023), no later editions or amendments are incorporated. These regulations are available FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ from the Colorado Department of Public Health and Environment at no cost at www.sos.state.co.us/CCR. These regulations are also available for public inspection and copying at the Colorado Department of Early Childhood, 710 S. Ash St., Denver, CO 80246, during regular business hours.. Colorado law requires that proof of immunization be provided prior to the first day of admission.

Reviewed 12 children's files and observed 2 files to be missing an immunization record. Correction: Obtain documentation of current immunization record and add to file. Correct by 07/02/2024

Corrected Corrected by Jul 2, 2024

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

2.321.A.5 · Health statements for children over two (2) years to seven (7) years of age must be updated in accordance with the American Academy of Pediatrics Recommendations for Preventive Pediatric HealthCare or as required in writing by health care provider.

Reviewed 12 children's files and observed 2 files having an expired health statement. Correction: Obtain documentation of current health statement and add to file. Correct by 08/02/2024

Corrected Corrected by Aug 2, 2024

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

2.321.B.8 · All medications in the family child care home, except those medications specified in the Department-approved medication administration training as emergency medications, must be locked and inaccessible to children, but available to the primary provider, applicant 2, equally qualified provider, qualified substitute, or staff members trained in administering medication.

Over the counter medication accessible to children in an unlocked cabinet in the bathroom. Correction: All medications in the family child care home, except those medications specified in the department approved medication administration training as emergency medications, must be locked and inaccessible to children. ***CORRECTED AT TIME OF VISIT*** Provider moved over the counter medication to a locked cabinet making it inaccessible to children. Correct by 07/02/2024

Corrected Corrected by Jul 2, 2024

Category: ratio. Marked corrected in the state record.

2.336.C.15 · The family child care home must contain at least one (1) fire extinguisher in working condition with the minimum weight of five (5) pounds, and minimum rating of 2A-10-BC as listed on the fire extinguisher label. The fire FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ extinguisher must be easily accessible or the identifying sign where the fire extinguisher is located must be highly visible.

Home having a 2.5 pound fire extinguisher. Correction: The family child care home must contain at least 1 fire extinguisher in working condition with the minimum weight of 5 pounds. Correct by 07/02/2024

Corrected Corrected by Jul 2, 2024

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