2.309.A.4.a · Staff aides must be at least sixteen (16) years of age and must work directly under the supervision of the primary provider in charge and responsible for the care of the children. If left alone with children, the staff aide must meet the same age and training requirements listed in rule sections 2.311, 2.312, and 2.313 as the primary provider, applicant 2, an equally qualified provider, or qualified substitute

At the time of visit arrived at the home and observed four unqualified staff aides alone supervising children. The primary provider was out of town. Correction: Immediately ensure that all staff aides work under direct supervision of the primary provider. Submit an action plan stating how you will come into compliance by 7/21/2024. Correct by 07/19/2024 ________________________________________________

Corrected Corrected by Jul 19, 2024

Category: supervision. 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.

At the time of the visit attempted to review 5 staff files and were unable to verify that a department-approved prevention of shaken baby/abusive head trauma training was completed. Correction: Immediately ensure all staff complete the department-approved training in prevention of shaken baby/abusive head trauma. Submit certificates and a written statement of compliance by 7/26/2024. Correct by 07/19/2024

Corrected Corrected by Jul 19, 2024

Category: recordkeeping. Marked corrected in the state record.

2.121.D.4.a · Criminal background check requests must be successfully completed 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-age child care facilities, family child care homes, and qualified exempt provider homes.

At the time of inspection attempted to review 5 staff files. Christiane S., Haylie S., Jaidah M., Rilee V, and Natalie D were missing a CBI/FBI clearance letter. Correction: All individuals requiring a background check must review Navigating the Background Check Investigation Unit's (BIU) Webpage powerpoint. Submit verification that staff member Natalie D, Jaidah M., and Rilee V. have reviewed the powerpoint within 24 hours. Submit documentation of Trails for staff members Christiane S., Haylie S., Natalie D, Jaidah M., and Rilee V with a written response to Specialist by 7/26/2024. Correct by 07/19/2024

Corrected Corrected by Jul 19, 2024

Category: supervision. Marked corrected in the state record.

2.312.F · Prior to working with children, the primary provider, applicant 2, the equally qualified provider, qualified substitutes, and all staff members must complete a building and physical premises training. The training must include identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, vehicular traffic, handing and storage of hazardous materials, and the appropriate storage of biological contaminants.:

At the time of the visit attempted to review 5 staff files and were unable to verify that a building and physical premises training was completed. Correction: Immediately ensure all staff complete the building and physical premises training. Submit a written statement of compliance by 7/26/2024. Correct by 07/19/2024

Corrected Corrected by Jul 19, 2024

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.

At the time of the visit attempted to review 5 staff files and were unable to verify that a department-approved training about child abuse prevention was completed. Correction: Immediately ensure all staff complete the department-approved training about child abuse prevention. Submit certificates and a written statement of compliance by 7/26/2024. Correct by 07/19/2024

Corrected Corrected by Jul 19, 2024

Category: recordkeeping. Marked corrected in the state record.

2.133.A · Prior to caring for children, all staff must complete a Department-approved training in emergency and disaster preparedness: Evacuation, Shelter in Place, Lockdown, and Active Shooter on Premises Plans for Children in Care. For seasonal children’s resident camp programs, operating no more than 90 days per calendar year, at least one on FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ site director must be trained in the Department approved training.

At the time of the visit attempted to review 5 staff files and were unable to verify that a department-approved training in emergency and disaster preparedness: Evacuation, Shelter in Place, Lockdown, and Active Shooter on Premises Plan for Children in care was completed. Correction: Immediately ensure all staff complete the department-approved training in emergency and disaster preparedness: Evacuation, Shelter in Place, Lockdown, and Active Shooter on Premises Plan for Children in care. Submit certificates and a written statement of compliance by 7/26/2024. Correct by 07/19/2024

Corrected Corrected by Jul 19, 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;

At the time of the visit attempted to review 5 staff files and were unable to verify that a department-approved First aid and CPR training was completed. Correction: Immediately ensure all staff complete the department-approved First aid and CPR training. Submit certificates and a written statement of compliance by 7/26/2024. Correct by 07/19/2024

Corrected Corrected by Jul 19, 2024

Category: recordkeeping. 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.

At the time of the visit attempted to review 5 staff files and were unable to verify that a department-approved basic First aid and CPR module training was completed. Correction: Immediately ensure all staff complete the department-approved basic First aid and CPR module training. Submit certificates and a written statement of compliance by 7/26/2024. Correct by 07/19/2024

Corrected Corrected by Jul 19, 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 FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ must be completed every three (3) years and can be applied towards ongoing annual training hours in the year that it is completed;

At the time of the visit attempted to review 5 staff files and were unable to verify that a department-approved course of training for medication administration training was completed. Correction: Immediately ensure all staff complete the department-approved course of training for medication administration. Submit certificates and a written statement of compliance by 7/26/2024. Correct by 07/19/2024

Corrected Corrected by Jul 19, 2024

Category: ratio. Marked corrected in the state record.

2.120.C.1.a · The Trails child abuse or neglect records request must be made on the state-prescribed form, accompanied by the required fee within the following required time frames: Child care centers (less than 24-hour care), school-age child care facilities, family child care homes, and qualified exempt providers must meet the following: 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.

At the time of inspection attempted to review 5 staff files. Jaidah M., Rilee V, and Natalie D were missing a Trails clearance letter. Correction: All individuals requiring a background check must review Navigating the Background Check Investigation Unit's (BIU) Webpage powerpoint. Submit verification that staff member Natalie D, Jaidah M., and Rilee V. have reviewed the powerpoint within 24 hours. Submit documentation of Trails for staff members Natalie D, Jaidah M., and Rilee V with a written response to Specialist by 7/26/2024. Correct by 07/19/2024

Corrected Corrected by Jul 19, 2024

Category: supervision. 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.

At the time of the visit attempted to review 5 staff files and were unable to verify that a department-approved standard precautions training was completed. Correction: Immediately ensure all staff complete the department-approved training in standard precautions. Submit

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

2.311.A.7 · Primary providers, applicant 2, equally qualified providers, qualified substitutes, staff members, and volunteers must demonstrate an interest in and knowledge of children and a concern for their proper care and well-being.

A 11 month old infant was placed in an unsafe sleep environment. Observed the infant covered with a blanket asleep in the Pack N Play. Correction: All infants must immediately be placed in a safe sleep environment. Immediately remove the blanket from the crib. Corrected at the time of the visit the infant woke up and they removed the infant from the crib. Submit a written statement of future compliance by 7/26/2024. Correct by 07/19/2024

Corrected Corrected by Jul 19, 2024

Category: physical safety. 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.

Identified that the provider and staff were required to complete the infant safe sleep training and all 5 staff members were missing training documentation for infant safe sleep, and a child in their care was found in an unsafe sleep environment. Correction: Immediately ensure that all safe sleep practices are followed, for all infants, at all times. Submit a written statement of compliance by 7/26/2024. Correct by 07/19/2024

Corrected Corrected by Jul 19, 2024

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

2.311.A.18 · Primary provider, applicant 2, equally qualified providers, qualified substitutes, and all staff must register with the Colorado Shines Professional Development Information System.

At the time of the visit, observed Riley, Natalie, and Haylie were not registered with Colorado Shines Professional Development Information System (PDIS). Correction: Immediately ensure all staff are registered with Colorado PDIS. Submit a written statement of compliance by 7/26/2024. Correct by 07/19/2024

Corrected Corrected by Jul 19, 2024

Marked corrected in the state record.

2.329.H.7 · All sleep/rest equipment must be safe, sturdy, and free from hazards including, but not limited to: broken or loose slats, torn mattress, chipping paint, and loose screws.

At the time of the visit, observed 6 sleeping mats that are torn and showing the foam mattress below. Correction: Immediately ensure all sleeping mats are safe and free from hazards. Submit pictures and a written statement of compliance by 7/26/2024. Correct by 07/19/2024

Corrected Corrected by Jul 19, 2024

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

2.121.D.5 · Every five (5) years, requests for FBI criminal record checks must be renewed by completing the fingerprint process at an approved vendor. An updated clearance letter or verification of the submission of the request must be obtained prior to five (5) years from the date reflected on the current clearance letter.

At the time of the visit, Haylie and Christiane were observed to have expired FBI fingerprint results. Haylie’s results expired on 8/31/2023 and Christiane’s expired on 6/19/2024. Correction: Immediately ensure the provider and all staff have current FBI fingerprint results that are updated every 5 years. Submit documentation of the completion of the fingerprints and a written statement of compliance by 7/26/2024. Correct by 07/19/2024

Corrected Corrected by Jul 19, 2024

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

2.319.A · An admission process must be completed prior to the child's attendance at the home and must include:

At the time of the visit, attempted to review 12 children's files and found 5 children were missing a complete file. Correction: Immediately review all children’s files and ensure all children have a complete file before the child’s attendance at the family child care home. Submit a written statement of compliance by 7/26/2024. Correct by 07/19/2024

Corrected Corrected by Jul 19, 2024

Marked corrected in the state record.

2.321.A.3 · Within thirty (30) days after admission, and within thirty (30) days following the expiration date, the parent(s) or guardian(s) of each child must submit a statement of the child’s current health status or written verification of a scheduled appointment with a health care provider. The statement of the child’s current health status must be signed and dated by a health care provider who has seen the child within the last twelve (12) months, or within the last six (6) months for children under two and one-half (2-1/2 ) years of age. The statement must include when the next visit is required by the health care provider. All health statements must be kept at the licensed family child care home.

At the time of the visit, reviewed 7 complete child files and found that 4 children’s files contained expired health status statements. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ Correction: Immediately review all children’s files and ensure that all children have a current health status statement. Submit a written statement of compliance by 7/26/2024. Correct by 07/19/2024

Corrected Corrected by Jul 19, 2024

Category: ratio. 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;

At the time of the visit, reviewed 7 complete child files and found that 4 child files were missing a current Emergency Medical Authorization form. Correction: Immediately review all child files and ensure all files contain a current Emergency Medical Authorization form. All emergency medical authorization forms need to be updated annually. Submit a copy of all emergency medical authorization and a written statement of compliance by 7/26/2024. Correct by 07/19/2024

Corrected Corrected by Jul 19, 2024

Category: health medication. 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 FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ must use their full signature. The parent/guardian must provide a signature on a weekly basis to verify the record.

At the time of the visit, observed the sign-in and out binder and observed 5 children were missing their individual sign-in and out forms. Correction: Immediately ensure that all children have a sign-in and out form. Submit a written statement of compliance by 7/26/2024. Correct by 07/19/2024

Corrected Corrected by Jul 19, 2024

Category: recordkeeping. Marked corrected in the state record.

7.707.41.B · The written policies and procedures must be developed, implemented and followed, which includes all updates, changes, and must include at a minimum the following information:

The provider indicated that last year they increased their fee's and verbally told parents of the change but did not put the change in fee's in writing and provide it to the parents. Correction: Ensure that written policies are followed and updated as changes occur. Provide documentation and statement of compliance by 9/5/2023. Correct by 09/05/2023

Corrected Corrected by Sep 5, 2023

Marked corrected in the state record.

7.707.6.D · Visitors Visits from all non-family members to the home must be on the sign in/out log, including the name, date, and arrival/departure times.

The provider indicated that sometimes other providers stop by to obtain paperwork or get things from her but do not sign into the program visitor log. Additionally, it was determined a woman who comes and reads to the program FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ weekly and another who teaches a dance class were not observed to have signed in on the visitor log. Correction: Ensure that visitors who are non-family sign in/out to the program when visiting. Provide statement of compliance by 9/5/2023. Correct by 09/05/2023 ________________________________________________

Corrected Corrected by Sep 5, 2023

Marked corrected in the state record.

7.707.32.A.10 · . Effective December 31, 2016 each provider, staff member or regular volunteer working with children less than three (3) years of age must complete a department-approved Prevention of Shaken Baby/Abusive Head Trauma training prior to working with children less than three (3) years of age. This training must be renewed annually and may count towards ongoing training requirements.

Christiane S. had an expired Shaken Baby training. Correction: Immediately ensure providers annually complete a Department-approved Shaken Baby/Abusive Head Trauma training. Provide documentation and statement of compliance by 9/5/2023. Correct by 08/22/2023

Corrected Corrected by Aug 22, 2023

Category: recordkeeping. Marked corrected in the state record.

7.707.32.A.11 · . Effective December 31, 2016 each provider, staff member or regular volunteer must complete a department-approved training about child abuse prevention, including common symptoms and signs of child abuse within thirty (30) calendar days of employment. This training must be renewed annually and may count towards ongoing training FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ requirements.

Christiane S. had an expired training about child abuse prevention. Correction: Ensure providers annually complete a Department-approved training about child abuse prevention. Provide documentation and statement of compliance by 9/5/2023. Correct by 09/05/2023

Corrected Corrected by Sep 5, 2023

Category: recordkeeping. Marked corrected in the state record.

7.707.32.A.4 · Prior to issuance of the license, the licensee and primary provider must complete:A State 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 and may be counted towards ongoing training requirements. This Standard Precautions training can be included as part of the Pre-Licensing training, in which case the total number of hours for Pre-licensing training required in 7.707.A1 is increased to sixteen (16) clock hours, and Standard Precautions training may count as no more than one (1) hour of the sixteen (16) clock hours; and,

Christiane S. had an expired Standard Precautions training. Correction: Immediately ensure providers annually complete a Department-approved standard precautions training. Provide documentation and statement of compliance by 9/5/2023. Correct by 08/22/2023

Corrected Corrected by Aug 22, 2023

Category: ratio. Marked corrected in the state record.

7.707.32.A.9 · . Effective December 31, 2016, each provider or staff member 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 within thirty (30) calendar days of employment. This training must be renewed annually and may count towards ongoing training requirements.

Christiane S. had an expired immunization training. Correction: Ensure providers annually complete a Department-approved CDPHE immunization course. Provide documentation and statement of compliance by 9/5/2023. Correct by 09/05/2023

Corrected Corrected by Sep 5, 2023

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

7.707.75.G · Safe Sleep Training for Family Child Care Staff All staff who work with infants must complete Department-approved safe sleep training prior to working with infants and on an annual basis. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________

Christiane S. had an expired safe sleep training. Correction: Immediately ensure providers who work with infants annually complete a department-approved safe sleep training. Provide documentation and statement of compliance by 9/5/2023. Correct by 08/22/2023

Corrected Corrected by Aug 22, 2023

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

7.707.923.A · All hazardous items and materials must be inaccessible to children including, but not limited to, office supplies, matches, plastic bags, cleaning and laundry materials, medicines, 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.

Two pairs of scissors were seen accessible to children on a low plastic shelf and on the kitchen counter. Additionally, Johnson's baby lotion, aquaphor and baby wipes labeled keep out of reach of children were accessible on the bathroom sink. Correction: Immediately ensure that hazardous items, and items labeled "keep out of reach of children" are inaccessible to children. Corrected at the time of visit my removing all hazardous items. Nothing additional needed. Correct by 08/22/2023

Corrected Corrected by Aug 22, 2023

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