2.206.A · At the time of enrollment, and upon amendments to policies and procedures, the center must give the parent(s)/guardian(s) the center’s policies and procedures and provide the opportunity to ask questions. Written copies must be available either electronically or in hard copy. The center must obtain a signed document stating that the parent(s)/guardian(s) have received the policies and procedures, and by signing the 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 2 children's files and observed 2 children lacking documentation of a signature provided by the parent/guardian for the program's policies and procedures. Correction: Immediately (9/9/2024) ensure that the program obtains and maintains documentation of a signed and dated policies and procedures document by the parent/guardian for all children. Provide a written statement of compliance within the overall response. Correct by 09/09/2024

Corrected Corrected by Sep 9, 2024

Marked corrected in the state record.

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 (2) children's files and observed (2) files lacking an authorization for emergency medical care Docusign Envelope ID: CF950F7A-14F1-467A-A5A9-1333BD8AF06C FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ signed and dated by a parent/guardian. Correction: Immediately (9/9/2024) ensure that the program obtains and maintains documentation of current written authorization for emergency medical care for all children in care. Provide a written statement of compliance within the overall response. Correct by 09/09/2024

Corrected Corrected by Sep 9, 2024

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

2.220.K · Topical preparations such as petroleum jelly, diaper rash ointments, sunscreen, insect repellent, and other ointments may be administered to children with written authorization from the parent(s)/guardian(s). These preparations may not be applied to open wounds or broken skin unless there is a written order by the prescribing health care provider.

Reviewed 2 childrens files and observed 2 childrens files lacking authorization from a parent or guardian for use of topical ointments. Correction: Immediately (9/9/2024) ensure that all children in care have parent/guardian authorization to administer topical preparations . Provide a written statement of compliance within the overall response. Correct by 09/09/2024

Corrected Corrected by Sep 9, 2024

Category: ratio. Marked corrected in the state record.

2.221.B · The center must apply sunscreen, have the parent(s)/guardian(s) apply sunscreen, or use another form of parent/guardian approved sun protection for children prior to children going outside. Sunscreen must be reapplied as directed by the product label.

Classroom lacking sun screen for children in care. Correction: Immediately (9/9/2024) ensure the center applies/reapplies sunscreen as directed by the product label, has the parent/guardian apply sunscreen, or uses another form of parent/guardian approved sun protection for children prior to children going outside. Provide a written statement of compliance within the overall resposne. Correct by 09/09/2024 Docusign Envelope ID: CF950F7A-14F1-467A-A5A9-1333BD8AF06C

Corrected Corrected by Sep 9, 2024

Marked corrected in the state record.

2.221.B.1 · When the parent(s)/guardian(s) applies sunscreen, the center must have a mechanism for documenting application times to ensure sunscreen is reapplied as directed by the product label. If documentation of application time is not available, the center must ensure that sunscreen is applied thirty (30) minutes before going outdoors. If the child will be outside for more than one (1) hour, sunscreen must be reapplied every two (2) hours.

Program lacking documentation of sunscreen application times from the parent/guardian and no sunscreen available for reapplication 30 minutes prior to going outdoors. Correction: Immediately (9/9/2024) ensure the center applies/reapplies sunscreen as directed by the product label, has the parent/guardian apply sunscreen, or uses another form of parent/guardian approved sun protection for children prior to children going outside. Provide a written statement of compliance within the overall resposne. Correct by 09/09/2024

Corrected Corrected by Sep 9, 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.

Reviewed attendance records and observed the document lacking transitions times for all children in care. Correction: Immediately (9/09/2024) ensure that the program maintains documentation of written attendance verification periodically throughout the day, to include during transitions . Provide a written plan of action along with a written statement of compliance within the overall response. Correct by 09/09/2024

Corrected Corrected by Sep 9, 2024

Category: recordkeeping. Marked corrected in the state record.

2.230.C.1.a · All climbing equipment eighteen (18) inches or higher must have resilient surfacing of at least six (6) inches in the use zone surrounding the equipment.

Little Tykes climbing structure with slide over 18 inches in height with 3" of pea gravel in the use zone. Correction: Immediately (9/9/2024) ensure that all climbing equipment over 18 inches has a department approved resilient surfacing of at least 6 inches. Provide a written statement of compliance within the overall response. Correct by 09/09/2024

Corrected Corrected by Sep 9, 2024

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