2.336.B.1 · Toys, toy parts, furnishings, equipment, and any materials accessible to children under three (3) years of age must not be a choke hazard or able to be inhaled.

In the downstairs bathroom in an unlocked drawer, small hairties were accessible to children under three (3) years of age, causing a potential choke hazard. Correction: Immediately, materials available to children under three (3) years of age must not be a choke hazard. Corrected at the time of visit, the provider removed the hair ties. Submit a written statement of future compliance by 7/28/2024. Correct by 06/28/2024

Corrected Corrected by Jun 28, 2024

Category: physical safety. 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 10 child files. Observed 2 children over two (2) years of age missing current documentation of a health statement. Correction: Children over two (2)) years of age must be updated in accordance with the American Academy of Pediatrics. Submit a written statement of compliance by 7/28/2024. Correct by 07/28/2024

Corrected Corrected by Jul 28, 2024

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 knives, cosmetics, shaving lotions, hair products, poisonous plants, and all items labeled by manufacturer as “keep out of reach of children.”

In the upstairs unlocked hallway bathroom; Aquafor, baby oil and hair products were accessible to children, causing a potential hazard. Correction: Immediately, all hazardous items must be inaccessible to children. Submit a written statement of compliance by 7/28/2024. Correct by 06/28/2024

Corrected Corrected by Jun 28, 2024

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.

In the upstairs hallway and unlocked bedrooms, outlets were not covered with a protective cover. Correction: Immediately, all outlets must have a protective cover. Submit a written statement of compliance by 7/28/2024. Correct by 06/28/2024

Corrected Corrected by Jun 28, 2024

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

2.336.C.11 · Flammable or combustible items must be stored in a locked area remote from the kitchen, and at least three (3) feet from the furnace, hot water heater or any other heating device. These items include, but are not limited to, paints, fuels, insecticides, and other hazardous chemicals.

A trashcan with dryer lint was within three (3) feet of the furnace and hot water heater. Correction: Flammable items msut not be store within three (3) feet of the furnace or hot water heater. Submit a written statement of compliance by 7/28/2024. Correct by 06/28/2024

Corrected Corrected by Jun 28, 2024

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

2.317.D.1 · Sign In/Out Procedure The provider must maintain a daily sign in/out method containing the date, the child's name, the time that the child arrived at and left the home, and the parent, guardian, or authorized person's signature. A full signature is required by the parent or guardian every time the child arrives at or leaves the home. The provider may sign in or out children who arrive directly from school or an activity as needed on a daily basis. The provider must use their full signature. The parent/guardian must provide a signature on a weekly basis to verify the record.

Reviewed the sign in/out procedure and observed 3 children signed in, however, 5 were in attendance. Correction: Immediately, children must be signed in and out with the child's name, the time the child arrives and leaves, and the parent/guardian's signature. Submit a written statement of compliance by 7/28/2024. Correct by 06/28/2024

Corrected Corrected by Jun 28, 2024

Category: recordkeeping. 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;

Reviewed the provider's file and observed expired CPR training dated 5/2024. Correction: Prior to working with children and every two (2) years, a cpr/first aid training must be completed. Submit documentation and a written statement of compliance by 7/28/2024. Correct by 06/28/2024

Corrected Corrected by Jun 28, 2024

Category: recordkeeping. 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.

Reviewed the household member's health evaluations and observed Chris M. lacking documentation of a health evaluation from a licensed physician. Correction: All members of the home must have a health evaluation signed by a licensed physician every two (2) years or as required in a written plan. Submit documentation and a written statement of compliance by 7/28/2024. Correct by

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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 10 child files. Observed 1 child under (2) years of age missing current documentation of a health statement. Correction: Children under two (2)) years of age must be updated in accordance with the American Academy of Pediatrics. Submit a written statement of compliance by 7/28/2024. Correct by 07/28/2024

Corrected Corrected by Jul 28, 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 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. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________

Reviewed 10 child files. Observed 3 missing current documentation of immunizations. Correction: Review all child files. All files must have updated immunization form. Submit a written statement of compliance by 7/28/2024. Correct by 06/28/2024

Corrected Corrected by Jun 28, 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 10 child files. Observed 2 children missing current documentation of a signed authorization for emergency medical care. Correction: Immediately, written authorization for emergency medical care must be signed and updated annually by the parent(s) or guardian(s). Submit a written statement of compliance by 7/28/2028. Correct by 06/28/2024

Corrected Corrected by Jun 28, 2024

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

2.321.B.11 · Topical preparations such as diaper rash ointments, sunscreen, insect repellants, sprays, and other ointments may be administered to children with written parent and/or guardian authorization. These preparations may not be applied to open wounds or broken skin unless there is a written order from a prescribing health care provider.

Reviewed 10 child files. Observed 2 files missing current documentation with signed authorization for topical preparations. Correction: Written authorization to administer topical preparations must be given by a parent/guardian. Submit a written statement of compliance by 7/28/2024. Correct by 06/28/2024

Corrected Corrected by Jun 28, 2024

Category: ratio. Marked corrected in the state record.

2.316.A · At the time of enrollment and upon any amendments to policies and procedures, the provider must give the parent(s) or guardian(s) a written statement of the family child care home's policies and procedures, and provide the opportunity to ask questions. Written copies must be available either electronically or in hard copy. The provider must obtain a signed document stating that the parent(s)/guardian(s) have received the policies and procedures. By signing the FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ policies and procedures document, the parent(s)/guardian(s) agree to follow, accept the conditions of, and give authorization and approval for the activities described in the policies and procedures.

Reviewed 10 child files. Observed 2 files missing documentation of a signed policy by the parent/guardian. Correction: At the time of enrollment, the parent/guardian must sign stating they have received a copy of the policy and procedure. Submit a written statement of compliance by 7/28/2024. Correct by 06/28/2024

Corrected Corrected by Jun 28, 2024

Marked corrected in the state record.

2.320.A.10 · 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: Written authorization for media use is required if the media use is not included in the written policies and procedures statement; including, but not limited to, television and video viewing, music, tablet and/or smart phone usage, video games, and computer use. The authorization must include approved time limits. The authorization form only needs to be on file if media use is not addressed in the home policies and procedures statement; and

Reviewed 10 child files. Observed 2 files missing signed documentation for media use. Correction: A written authorization for media use must be signed by a parent/guardian. Submit a written statement of compliance by 7/28/2024. Correct by 07/28/2024

Corrected Corrected by Jul 28, 2024

Category: recordkeeping. Marked corrected in the state record.