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.

Reviewed 9 children's files and 3 children were lacking a health statement and have been attending care for more than 30 days. Correction: Ensure that all children in care must have a current health statement within the first 30 days of enrollment. Correct and respond with an on going plan of compliance by 9/7/2024. Correct by 09/07/2024

Corrected Corrected by Sep 7, 2024

Category: ratio. 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 9 children's files and 2 children over the age of 2 were lacking a current health statement. Correction: Ensure that all children over the age of 2 must have a current health statement. Correct and respond with verification of compliance by 9/7/2024. Correct by 09/07/2024

Corrected Corrected by Sep 7, 2024

Category: health medication. 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 4 staff files and 1 staff member Carlisle was lacking a shaken baby/ abusive head trauma training. Correction: Ensure all staff member must complete a shaken baby/ abusive head trauma training prior to working with children. Correct immediately and respond with verification of compliance by 9/7/2024. Correct by 08/08/2024

Corrected Corrected by Aug 8, 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.

Reviewed 4 staff files and 1 staff member Carlisle was lacking a safe sleep head trauma training. Correction: Ensure all staff member must complete a safe sleep head trauma training prior to working with children. Correct immediately and respond with verification of compliance by 9/7/2024. Correct by 08/08/2024

Corrected Corrected by Aug 8, 2024

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

2.138.A · Emergency drills, lockdown and active shooter on premises drills must be held at least quarterly but FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ often enough so that all occupants are familiar with the drill procedure and their conduct during a drill is a matter of established routine. Fire drills must be held monthly and be consistent with local fire department procedures. Tornado drills must be held monthly from March to October. A record of all emergency drills held over the past twelve (12) months must be maintained by the facility or center, including date and time of drill, number of adults and children participating, and the amount of time taken to evacuate.

The provider was lacking the emergency log for all drills. Correction: Ensure that the provider must complete and document all drills fire, tornado, shelter in place, and active shooter. Correct immediately and repond with a plan of on going plan of compliance by 9/7/2024. Correct by 08/08/2024

Corrected Corrected by Aug 8, 2024

Category: recordkeeping. 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.

Reviewed 4 staff files and 1 staff member Carlisle was lacking a standard precaution training. Correction: Ensure all staff member must complete a standard precaution training prior to working with children. Correct immediately and respond with verification of compliance by 9/7/2024. Correct by 08/08/2024

Corrected Corrected by Aug 8, 2024

Category: ratio. Marked corrected in the state record.

2.317.E.1 · 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.

There were 4 family members who came to visit as well as a child's specialist and there was no one signed in on the visitor log. Correction: All visitors must sign in on the visitor log when visiting the home during child care hours. ***Corrected at the time of the visit everyone signed in*** Respond with a plan of on going compliance by 9/7/2024. Correct by 08/08/2024

Corrected Corrected by Aug 8, 2024

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.”

There was a container of Tea Tree Oil labeled "keep out of reach of children"sitting on the window ledge in the kitchen accessible to children. Also there was a large bottle of hand sanitizer labeled "keep out of reach of children" FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ sitting on a container in a hallway accessible to chidren. Correction: Ensure that all items labeled keep out of reach of children must be inaccessible to children. ***Corrected at the time of the visit the provider moved the Tea Tree Oil and the hand saniziter.*** Repond with a plan of on going compliance by 9/7/2024. Correct by 08/08/2024

Corrected Corrected by Aug 8, 2024

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

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.

Licensing Specialist asked the provider how many children were in care and the provider stated 8 children and there were 9 children present. Correction: Ensure that the provider must demonstrate proper care and well-being of child including how many children are in care. ***Corrected at the time of the visit the provider completed a count of children.***Repond with a plan of on going compliance by 9/7/2024. Correct by 09/07/2024

Corrected Corrected by Sep 7, 2024

Marked corrected in the state record.

2.324.A.6 · Hand washing areas shall be routinely disinfected when visibly dirty and after any use of the area for tasks other than hand washing including immediately after the sink is used to clean tanks, feeders, water containers and any equipment used by pets or animals.

Durning the walk through of the facility lciensing specialist observed the children's restroom sink was dirty. Also the wall next to the hand washing sink had a black and orange residue running down the wall. Correction: Ensure that that handwashing areas shall be routinely disinfected when visibly dirty. Correct immediatly and respond with verification (photos of sink and bathroom walls) of compliance by 7/29/2024. Correct by 07/16/2024

Corrected Corrected by Jul 16, 2024

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

2.336.A.2 · The large home must provide sufficient floor space in the specific room(s) designated for use for child care that does not All floors must have an easily cleanable finish including, but not limited to: carpets, tile, wood, or concrete. space used by household furniture.

The child care area is located on the main level of the home and all the floors were dity and had black residue spots throughout the main level. Correction: Ensure that the home must have easily cleanable finish floors. Correct and repond with verification (phots of the floors) of compliance by 7/29/2024. Correct by 07/16/2024 ________________________________________________

Corrected Corrected by Jul 16, 2024

Marked corrected in the state record.

2.120.C.2 · The Trails child abuse or neglect records request must be made on the state-prescribed form, FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ 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: All other requests except those specified in rule section 2.120(C)(1) must be submitted within ten (10) calendar days of the first day of employment for each employee or facility.

Reviewed 2 staff files 1 staff member Sabrina Bynes was lacking 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 Sabrina Bynes has reviewed the powerpoint within 24 hours. Submit documentation of TRAILS Clearance Letter for staff member Sabrina Bynes with written response to Specialist by 7/29/2024. Correct by 07/16/2024

Corrected Corrected by Jul 16, 2024

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

2.317.E.1 · 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.

There were two visitors at the facility at the time of the inspection and both visitors were not signed in on the visitor log. Correction: Ensure that all visitors from all non-familiy members to the home must be signed in and out on the visitor log. ***Coreected at the time of the visit the provider has the two visitors sign in on the visitor log.*** Respond with verification of complaine by 7/29/2024. Correct by 07/16/2024

Corrected Corrected by Jul 16, 2024

Marked corrected in the state record.

2.329.E · Toddlers, preschoolers, and older children, as necessary, must have a suitable mat at least two inches thick, cot, bed, or sofa, with a clean washable sheet and blanket or other suitable covering that has been laundered between uses by different children.

Licensing Specialist completed a walk of the facility and observed all 7 children who were napping on a cot did not have a sheet on the cot/mat. Correction: Ensure that toddlers, preschools, and older children must have a cot/mat with a sheet and blanket. Correct immediately and respond with verification of complaince by 7/29/2024. Correct by 07/16/2024

Corrected Corrected by Jul 16, 2024

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 the purple classroom there was an outlet missing a outlet cover, in the living room with the black couch there was a power strip missing several outlet outlet covers. Also in the purple classroom there was a charging cord laying on the ground next to the cozy area that was posing a strangulation hazard. Correction: Enusre that in rooms that are accessible to children all outlets must have protective covers. Ensure that all electrical cords must be in good condition and must not pose a saftety hazard. ***Corrected at the time of the visit the provider picked up the cord and placed it inaccessible to children.*** Correct immediately and respond with verification of compliance by 7/29/2024. Correct by 07/16/2024

Corrected Corrected by Jul 16, 2024

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

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 purple classroom there were small pom-poms, feathers, and glue sticks with small lids accessible to children less than 3 years old. The small pom-poms, feathers, and glue sticks were posing a choking hazard. Correction: Ensure that all items able be inhaled including the small pom-poms, feathers, and glue sticks that pose a choking hazard must be not be made accesible to children under the age of 3 years old. ***Correted at the time of the visit the provider removed the items and placed the items in a gated area inaccessible to children. No need for a written statement of complaince.*** Correct by 07/16/2024

Corrected Corrected by Jul 16, 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 FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ to, paints, fuels, insecticides, and other hazardous chemicals.

There were two large 5 gallon containers of flammable paint sitting in the hallway leading to the kitchen and accessible to children. Correction: Enusre that flammable items including paint must be stored in a locked area remote from the kitcken. ***Corrected at the time of the visit the provider placed the two 5 gallon paint containers in the locked basement.*** Respond with verification of compliance by 7/29/2024. Correct by 07/16/2024

Corrected Corrected by Jul 16, 2024

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

2.337.D.2 · All outdoor play areas shall frequently be surveyed and must be kept safe and free from hazardous materials or debris that could cause harm to children.

Outside in the backyard play area ther was a lot of debris inclduing a broken plastic fork with a sharp edge, a green plastic tent stake, as well as many torn plastic cups all over the play area. Correction: Ensure that the play area shall frequently be surveyed and must be kept safe and free of hazards including debris like a broken plastic fork with a sharp edge, a green plastic tent stake, as well as many torn plastic cups all over the play area. ***Corrected at the time of the visit the provider cleaned up all the debris includuing a broken plastic fork with a sharp edge, a green plastic tent stake, as well as many torn plastic cups all over the play area.*** Respond with a plan of on going complaince by 7/29/2024. Correct by 07/16/2024

Corrected Corrected by Jul 16, 2024

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

2.336.A.3 · Interior walls must be free of holes and constructed of solid material with a smooth finish that can be easily cleaned. Painted finishes shall be maintained free from peeling, chipping or otherwise deteriorating paint.

In the purpule and main classrooms there was peeling paint in many different areas of the classrooms. Also in the restroom there was a large hole in the wall and there was exposed plumging pipes. Correction: The facility must ensure that the interior walls must be free of holes and painted finishes shall be maintained free of peeling, chipping, or otherwise deteriorating paint. Correct immediately and respond with verififcation (photos of the walls as well as the wall in the bathroom) of complaince by 7/29/2024. Correct by 07/16/2024

Corrected Corrected by Jul 16, 2024

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 main living room classroom there was a purse sitting on a shelf accessible to children. In the kitchen there was a bottle of Dawn Soap labeled "keep out of reach of children in the unlocked cabinet under the sink. There were FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ dishwasher pods labeled "keep out of reach of children" accessible to children in an unlock kitchen cabinet near the back door. There was a empty plastic bag on the ground near the stairs as well as in an unlocked cabinet in the kitchen. There were two boxes of reynolds wrap that have the sharp edge accessible to children in an unlocked kitchen drawer. Correction: Ensure that all the hazardous items listed above must be made inaccessible to children. ***Corrected at the time of the viist the provider places all the items listed above in a high kitchen cabinet and in a gated off area inaccessible to children.*** Respond with an on going plan of compliance by 7/29/2024. Correct by 07/16/2024

Corrected Corrected by Jul 16, 2024

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

2.311.A.13.a · All equally qualified providers, qualified substitutes, and staff members must obtain a medical statement signed and dated by a licensed physician or other health care provider within thirty (30) days of employment.

Reviewed 2 staff files and 1 staff member Liliana Castro-Lopez was lacking a health statement and had been workimg at the facility for longer than 30 days. Correction: Review and ensure that all staff members including Liliana Castro-Lopez must have a current health statement within 30 days of employment. Correct and respond with verification of compliance by 7/29/2024. Correct by 07/29/2024

Corrected Corrected by Jul 29, 2024

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

7.707.923.B · In rooms accessible to children, all electrical outlets and power strips must nave protective covers, or safety outlets must be installed; and all exposed light bulbs must have protective covers. Electrical cords must be in good condition and not posing a hazard, such as strangulation, falling or tripping.

In the playroom by the puzzle shelf there was an uncovered outlet. Correction: Ensure that all outlets in rooms accessible to children all outlets must have a protective covers. . Correct immediately and respond with verification of compliance by 10/11/2023. Correct by 09/11/2023

Corrected Corrected by Sep 11, 2023

Category: physical safety. 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 requirements.

Reviewed 3 staff files and 1 staff member Charlotte had an expired child abuse prevention training. Also 1 staff member Lily was lacking a child abuse prevention training prior to working with children. Correction: Review and ensure all staff must have a child abuse prevention training and renew annually. Correct immediately and respond with verification of compliance by 10/11/2023. Correct by 09/11/2023

Corrected Corrected by Sep 11, 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,

Reviewed 3 staff files and 1 staff members Charlotte had expired standard precautions training. Also 1 staff member lily did not have a standard precautions training. Correction: Review and ensure all staff must have a standard precautions training and renew annually. Correct immediately and respond with verification of compliance by 10/11/2023. Correct by 09/11/2023

Corrected Corrected by Sep 11, 2023

Category: ratio. Marked corrected in the state record.

7.707.32.A.7 · Prior to issuance of the license the licensee and primary provider must complete: The State Department approved course of training for medication administration.

Reviewed 2 staff files and 1 staff member Charlottle had an expired medication administartion traning. Also Gabby had a medication administrartion training but did not have part 2 completed Correction: Review and ensure all staff members who have a current medication administration must complete part 1 and two. Correct and respond with verification of compliance by 10/11/2023. Correct by 10/11/2023

Corrected Corrected by Oct 11, 2023

Category: ratio. Marked corrected in the state record.

7.707.71.A.5 · Statements of health status of children under two (2) years of age must be updated in accordance with the national pediatric recommended schedule for routine health supervision or as required in writing by health care provider.

Reviewed 6 children's files and 2 children over the age of 2 expired health statements. Correction: Review and ensure that all children over the age of 2 must have a current health statement. Correct and respond with verification of compliance by 10/11/2023. Correct by 10/11/2023

Corrected Corrected by Oct 11, 2023

Category: supervision. 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.

In the playroom there was a container of disinfectant wipes on the art shelf accessible to children that was labled keep out of reach of children. Also in the kicthen there were several large kitchen knives located in an unlocked drawer accessible to children. Correction: Ensure that all hazardous items including container of disinfectant wipes and several large kitchen knives. ***Corrected at the time of the provider removed and placed all items on a high shelf making all items inaccessible to children*** Respond with verification of compliance by 10/11/2023. Correct by 09/11/2023

Corrected Corrected by Sep 11, 2023

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

7.707.31.A.10 · Subsequent health evaluations for the provider and children residing in the home who are less than twelve (12) years of age must be submitted every two (2) years or as required in a written plan signed by a physician or other health professional. A new family member and/or a new resident of the home must submit to the State Department, within thirty (30) days from the date the individual began living in the home, a State Department approved health evaluation form signed and dated by a licensed physician or other health professional.

Reviewed 3 staff files and all three were lacking a current health statement. Correction: Review and ensure that all staff members must have a current health statement. Correct and respond with verification of compliance by 10/11/2023. Correct by 10/11/2023

Corrected Corrected by Oct 11, 2023

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

7.701.100.A · . Prior to caring for children, all staff must complete a State Department-approved training in emergency and disaster preparedness. For seasonal children's resident camp programs, operating no more than 90 days FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ per calendar year, at least one on site director must be trained in the State Department-approved training

Reviewed 3 staff files and 1 staff member Lily was lacking an emergency and preparedness training prior to workingh with children. Correction: Review and ensure all staff members complete an emergency and preparedness training prior to workingh with children. Correct immediately and respond with verification of compliance by 10/11/2023. Correct by 09/11/2023

Corrected Corrected by Sep 11, 2023

Category: recordkeeping. Marked corrected in the state record.

7.707.934.B · All outdoor play areas shall frequently be surveyed and must be kept safe and free from hazardous materials or debris that could cause harm to children

Outside there were several pieces of broken plastic spoons with sharp edges, and two pieces of broken plastic parts with sharp edges. Correction: Review and ensure all outdoor areas must be kept safe and free of hazard. ***Corrected at the time of the visit the staff members picked up the broken spoons and two pieces of plastic and made them inaccessible to children.*** No need for written statement of compliance.*** Correct by 09/11/2023

Corrected Corrected by Sep 11, 2023

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

7.707.922.A · Toys, toy parts and any material accessible to children under three (3) years of age must be large enough that they cannot be swallowed or inhaled, to prevent a choking hazard.

In the playroom there were several small items like broken crayons, small lid, small foam letters located on the puzzle and art shelf posing a choking hazard. Correction: Ensure that all items accessible to children under 3 must not be a choking hazard. ***Corrected at the time of the visit the provider removed all items and made them inaccessible to children. Respond with verification of compliance by 10/11/2023.*** Correct by 09/11/2023

Corrected Corrected by Sep 11, 2023

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

7.707.36.B.2 · The personnel files for each employee, substitute, and volunteer shall include: Information received from the state automated systems check on child abuse

Reviewed 3 staff files and 1 staff member Lily was lacking a copy of the 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 Lily C.L have reviewed the powerpoint within 24 hours.

Open Not marked corrected in the state record

Category: background checks. Open / not marked corrected.

7.707.91.D · The premises of the family child care home must be kept safe and free from hazards to health at all times

In the playroom near the puzzle shelf there were 4 hole and peeling paint. Also the tile in the bathroom under the toilet was missing. Also in the kitchen the flooring was coming up and posing a tripping hazard. Correction: Ensure that the family child care home must be kept safe and free from hazard. Correct immediately and respond with verification of compliance by 10/11/2023. Correct by 09/11/2023

Corrected Corrected by Sep 11, 2023

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