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.

In the Roly Poly classroom, observed 7 children in attendance, however SM1 stated they had 6 children and 6 children were signed in on the attendance verification sheet. Correction: The time a child arrives and leaves the center each day must be recorded. **Corrected at time of visit, staff member corrected the attendance verification on 12/15/25.** No response is required. Correct by 12/15/2025

Corrected Corrected by Dec 15, 2025

Category: recordkeeping. Marked corrected in the state record.

2.224.B.2 · All infants less than six (6) months of age must be held for bottle feeding. Bottles must not be propped. Older infants must not be allowed to hold their own bottles when lying flat. Bottles must not be allowed in a crib with the infant.

In the Bearsie Bears classroom, observed 9 month old infant laying flat while holding their own bottle. Correction: Older infants must not be allowed to hold their own bottles when lying flat. **Corrected at time of visit, staff member held infant while feeding on 12/15/25.** No response is required. Correct by 12/15/2025

Corrected Corrected by Dec 15, 2025

Marked corrected in the state record.

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

In the Cowboy Bunnies classroom, observed blue round rug to be tearing and causing a potential safety FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ hazard. Correction: Keep all indoor and outdoor equipment, materials and furnishings sturdy, safe, and free of hazards. **Corrected at time of visit, staff member cut the loose fabric on 12/15/25.** No response is required. Correct by 12/15/2025

Corrected Corrected by Dec 15, 2025

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

2.229.C · Items labeled “keep out of reach of children” must be inaccessible to children.

In the Art Room, observed the staff lounge door to be locked but not closed. Potting soil labeled "keep out of reach of children" was accessible to children and posing a potential safety hazard. Correction: Keep all items labeled "keep out of reach of children" inaccessible at all times. **Corrected at time of visit, staff member closed the door making the potting soil inaccessible to children on 11/19/25.** No response is required. Correct by 11/19/2025

Corrected Corrected by Nov 19, 2025

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

2.229.L · Toys, toy parts, furnishings, equipment, and any materials accessible to children under than three (3) years of age must not be a choke hazard or able to be inhaled. Any area of the facility accessible to children less than three (3) years of age must be free of any choke or inhalation hazards.

In the Friendly Sea Turtles classroom, observed uncooked beans in the sensory bin accessible to children FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ under the age of three and posing a potential choking hazard. Correction: All materials accessible to children under three years of age must not be a choke hazard. **Corrected at time of visit, staff member removed the beans from the sensory table on 11/19/25.** No response is required. Correct by 11/19/2025

Corrected Corrected by Nov 19, 2025

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

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

In the Art Room, observed the staff lounge door to be locked but not closed. An extension cord longer than 18 inches was accessible to children and posing a potential safety hazard. On the toddler playground, foam protector on the steps was not securely attached and a nail was coming loose, posing a potential safety hazard. Correction: Indoor and outdoor equipment, materials and furnishings must be sturdy, safe and free of hazards. **Corrected at time of visit, staff member closed the staff door and removed the foam protector on 11/19/25.** No response is required. Correct by 11/19/2025

Corrected Corrected by Nov 19, 2025

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

2.209.B.4 · The center must maintain and update annually and upon changes, a record on each child that includes: A copy of the child’s health statement completed by a health care provider

Reviewed 14 child files. Observed CH8, CH9 and CH13's file lacking current documentation of a health statement completed by a health care provider. Correction: Obtain a health statement completed by a health care provider annually for all children. Correct and submit a statement of compliance by 12/19/2025. Correct by 12/19/2025

Corrected Corrected by Dec 19, 2025

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

2.212.G · All staff members must submit to the center a medical statement, signed and dated by a physician or other health care provider, verifying that they are in good mental, physical, and emotional health appropriate for the position for which they have been hired. This statement must be dated no more than six (6) months prior to employment or within thirty (30) calendar days after the first date of employment. Subsequent self-reported health histories must be submitted annually.

Reviewed 7 staff files. Observed SM4's file (DOH 8/18/25) lacking documentation of a medical statement, signed and dated by a physician or other health care provider. Correction: Obtain a medical statement, signed and dated by a physician or other health care provider. Correct and respond with statement of compliance by 11/1/2025. Correct by 11/01/2025

Corrected Corrected by Nov 1, 2025

Category: health medication. 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 31 staff files and observed ECT Ruby P., Aide Taylor C, Aide Janet C, and ECT Danielle G's files to have expired TRAILS clearance letters. Correction: Every 5 years, all child abuse and neglect inquiry background checks must be renewed and clearance letters available for review. All individuals requiring a background check must review Navigating the Background Check Investigation Unit's (BIU) Webpage powerpoint. Submit verification that staff members Ruby, Taylor, Janet, and Danielle have reviewed the powerpoint within 24 hours. Submit documentation of TRAILS Clearance Letters for staff members Taylor, Ruby, Janet, and Danielle with written response to Specialist by 1/24/24. Correct immediately and respond with verification of compliance by 2/17/24. Correct by 01/17/2024

Corrected Corrected by Jan 17, 2024

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

2.213.C · Staff working with infants less than twelve (12) months old must complete a Department-approved safe sleep training prior to working with infants less than twelve (12) months old. This training must be renewed annually and will be counted towards ongoing professional development.

Identified through Director statement that ECT Ruby works with children less than 12 months old. Reviewed FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ 31 staff files and observed ECT Ruby to be missing documentation of completion of Department-approved safe sleep training. Correction: Obtain documentation of completion of Department-approved safe sleep training for Ruby, and annually thereafter. Correct immediately and respond with verification of compliance by 2/17/24. Correct by 01/17/2024

Corrected Corrected by Jan 17, 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.

Reviewed 31 staff files and observed ECT Danielle G's files to have an expired FBI clearance letter. Correction: Every 5 years, FBI criminal record checks must be renewed and clearance letters available for review. All individuals requiring a background check must review Navigating the Background Check Investigation Unit's (BIU) Webpage powerpoint. Submit verification that staff member Danielle have reviewed the powerpoint within 24 hours. Submit documentation of FBI clearance letter for staff member Danielle with written response to Specialist by 1/24/24. Correct immediately and respond with verification of compliance by 2/17/24. Correct by 01/17/2024

Corrected Corrected by Jan 17, 2024

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

2.121.J.1 · 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-age child care facilities, family child care homes, and qualified exempt provider homes:

Reviewed 31 staff files and observed Kristen K, Kiara W, Sharon L, Holly P, Victoria S, Renee C, A.K., Nicole W, and Kelsie B's files to be missing documentation of out of state clearance letter. Correction: All individuals requiring a background check must review Navigating the Background Check Investigation Unit's

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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 13 child files and observed nine children to be missing current documentation of an emergency medical authorization. Correction: Obtain emergency medical authorization for all children and annually thereafter. Correct immediately and and respond with a statement of compliance by 2/17/24. Correct by 01/17/2024

Corrected Corrected by Jan 17, 2024

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

2.219.B.2 · Within thirty (30) calendar days of admission, and within thirty (30) calendar days following the expiration date of a previous health statement, the parent(s)/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 less than two and one-half (2½) 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 center.

Reviewed 13 child files and observed two child files to be missing documentation of a current and complete health statement signed by a health care provider. Correction: Obtain and maintain current and complete documentation of health statements for all enrolled children. Correct immediately and and respond with a statement of compliance by 2/17/24 Correct by 02/17/2024

Corrected Corrected by Feb 17, 2024

Category: ratio. Marked corrected in the state record.

2.212.D · Staff must not use marijuana and marijuana infused products, tobacco products of any kind, or alcohol in the presence of children. To prevent exposure to secondhand smoke, child care centers must prohibit the use of tobacco and marijuana products on all center property, both indoors and outdoors. All marijuana and marijuana infused products, vaping and tobacco products, and alcohol must be kept inaccessible to children at all times.

During walk through observed sealed bottles of wine in Director office. Correction: Ensure any rooms accessible to children do not have alcohol that is accessible. Correct immediately and respond with statement of compliance by 1/24/24. **Corrected at time of visit. Director moved sealed wine to a locked storage room.** No response required. Correct by 01/17/2024

Corrected Corrected by Jan 17, 2024

Marked corrected in the state record.

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

Reviewed 31 staff files and observed ECT Ruby to be missing documentation of completion of Department-approved standard precautions training. Correction: Obtain documentation of completion of Department-approved standard precautions training for Ruby, and annually thereafter. Correct immediately and respond with verification of compliance by 2/17/24. Correct by 01/17/2024

Corrected Corrected by Jan 17, 2024

Category: recordkeeping. Marked corrected in the state record.

2.213.G · Within thirty (30) calendar days of employment, all employees and regular volunteers must be trained using a Department-approved training about child abuse prevention, which includes common symptoms and signs of child abuse, how to report, where to report, and when to report suspected or known child abuse or neglect. This training must be renewed annually.

Reviewed 31 staff files and observed ECT Ruby and ECT Sharon to be missing documentation of completion of Department-approved training about child abuse prevention. Correction: Obtain documentation of completion of Department-approved training about child abuse prevention for Ruby and Sharon, and annually thereafter. Correct immediately and respond with verification of compliance by 2/17/24. Correct

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

2.213.D · Staff 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 every two (2) years and will be counted towards ongoing professional development.

Identified through Director statement that ECT Sandi works with children less than three years old. Reviewed 31 staff files and observed ECT Ruby to be missing documentation of completion of Department-approved prevention of shaken baby/abusive head trauma training. Correction: Obtain documentation of completion of Department-approved prevention of shaken baby/abusive head trauma training for Sandi, and every two years thereafter. Correct immediately and respond with verification of compliance by 2/17/24. Correct by 01/17/2024

Corrected Corrected by Jan 17, 2024

Category: recordkeeping. Marked corrected in the state record.

2.229.E · Thumb tacks must not be used in areas accessible to children less than three (3) years of age.

During walk through, observed thumb tacks used in hallway accessible to children less than 3 years of age. Correction: Ensure all areas accessible to children less than 3 years of age, do not have thumb tacks made accessible. **Corrected at time of visit. Director ensured all tacks were removed for Specialist review. ** No response required. Correct by 01/17/2024

Corrected Corrected by Jan 17, 2024

Marked corrected in the state record.

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.

During walk through, observed the Bears classroom to not have a completed written attendance verification. Correction: Staff members must complete written attendance verification periodically throughout the day, including transitions. **Corrected at time of visit, ECT Ruby completed attendance verification for Specialist to review.** No response required. Correct by 01/17/2024

Corrected Corrected by Jan 17, 2024

Category: recordkeeping. Marked corrected in the state record.