2.223.A.1 · All children must be under the direct supervision at all times of a qualified adult who has been assigned the responsibility to supervise

Identified through a discuss with staff, that they did not observe three children urinating in the playhouse on the playground. Correction: All children must be under the direct supervision of an adult at all times. Correct immediately by 7/16/25 and submit written statement of compliance with overall response by 7/23./25 Correct by 07/16/2025 ________________________________________________ Stage II Licensing Concern :

Corrected Corrected by Jul 16, 2025

Category: supervision. Marked corrected in the state record.

2.229.H · Sharp tools and instruments must be stored in areas inaccessible to children.

a pair of adult scissors on a shelf in the Pete the Cat classroom accessible to children. Correction: Sharp tools must be stored in areas inaccessible to children. Correct immediately by 7/16/25. Corrected at the time of visit by the Director putting them in an area inaccessible to children. No written response is required. Correct by 07/16/2025

Corrected Corrected by Jul 16, 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.

The weed guard was exposed in a small area on the toddler playground, which is a potential tripping hazard. Correction: Indoor and outdoor equipment, materials and furnishings must be sturdy, safe and free from hazards. Correct immediately by 7/16/25. Corrected at the time of visit by the Director burying the exposed weed guard. No written response is required. Correct by 07/16/2025

Corrected Corrected by Jul 16, 2025

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

2.217.A.9 · At least one (1) staff member with the current Department-approved medication administration training and delegation must be on duty at all times.

Observed both the Director (L Deuschle) and Asst Director E Olson) to have Medication Administration part I, but not part II. Both staff members had current medication admin delegation. Correction: At least one staff member with a current Department approved Medication Administration trianing must be on duty at all times. Correct immediately by 1/23/25 and submit written statement of compliance with overall response by 2/23/25. Correct by 01/23/2025

Corrected Corrected by Jan 23, 2025

Category: ratio. Marked corrected in the state record.

2.216.B.2.a · In the infant program, there must be a qualified infant program supervisor present sixty percent (60%) of the hours of operation of the infant program who is responsible for the care of the infants. An individual qualified as an infant early childhood teacher must be responsible during the remaining time.

Reviewed 8 staff files and observed the staff member in the infant room, S Ruff, to be missing documentation of IPS qualifications and the IPS staff member, M Lindblad, to be working at another job today. Previously cited 2/27/24. Correction: There must be a qualified IPS present 60% of the hours of operation of the infant program who is responsible for the care of the infants. Correct immediately by 1/23/25 and submit written statement of compliance with overall

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

2.216.B.1.c.1 · Prior to being assigned a group of children, the infant program early childhood teacher must complete eight (8) hours of orientation in the infant program under the supervision of the infant program supervisor. The orientation may include, but not limited to, the following topics: Toys and equipment, appropriate activities for infants and toddlers, appropriate sleep positions for infants and toddlers, and the safe and appropriate diaper change technique.

Reviewed 8 staff files and observed the staff member in the infant room, S Ruff, to be missing documentation of an 8 hour orientation to the infant program. Correction: Prior to being assigned a group of children, the infant program early childhood teacher must complete an 8 hour orientation in the infant program. Correct immediately by 1/23/25 and submit written statement of compliance with overall response by 2/23/25. Correct by 01/23/2025

Corrected Corrected by Jan 23, 2025

Category: supervision. 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 8 staff files and observed 1 staff member, K Roberts (DOH 6/6/24) to be missing documentation of a health statement within 30 calender days of hire. Correction: Obtain a health statement of the staff member missing it and maintain in their files. Correct and submit written statement of compliance with overall response by 2/23/25. Correct by 02/23/2025

Corrected Corrected by Feb 23, 2025

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

2.213.B · All staff must complete a Department-approved standard precautions training prior to working with FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ children. This training must be renewed annually and will be counted towards ongoing professional development.

Reviewed 8 staff files and observed 1 staff member, D Falk (DOH 1/7/25) to be missing documentation of a current Department approved Standard Precautions training prior to working with children. Correction: Obtain documentation of a current Department approved Standard Precautions training for the staff member listed above. Correct immediately by 1/23/25 and submit written statement of compliance with overall response by 2/23/25. Correct by 01/23/2025

Corrected Corrected by Jan 23, 2025

Category: recordkeeping. Marked corrected in the state record.

2.216.C.3 · For every fifteen (15) or fewer toddlers, there must be at least one (1) staff member in the toddler program at all times who has a current Department-approved first aid and safety certificate that includes (CPR) for all ages of children.

Reviewed 8 staff files and observed the staff members in the toddler room, D Falk and K Roberts, to be missing documentation of a Department approved First Aid and CPR certification. Correction: There must be at least one staff member on duty in each toddler room at all times that holds a current Department approved First Aid and CPR certification. Correct immediately by 1/23/25 and submit written statement of compliance with overall response by 2/23/25. Correct by 01/23/2025

Corrected Corrected by Jan 23, 2025

Marked corrected in the state record.

2.216.B.1.e · There must be at least one (1) staff member on duty in each infant room at all times who holds a current Department-approved first aid and safety certificate that includes cardiopulmonary resuscitation (CPR) for all ages of children.

Reviewed 8 staff files and observed the staff member in the infant room, S Ruff, to be missing documentation of a Department approved First Aid and CPR certification. Previously cited 2/27/24. Correction: There must be at least one staff member on duty in each infant room at all times that holds a current Department approved First Aid and CPR certification. Correct immediately by 1/23/25 and submit written statement of compliance with overall response by 2/23/25. Correct by 01/23/2025

Corrected Corrected by Jan 23, 2025

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 4 children's files and observed one child to have an expired health statement, one child to be missing documentation of a health statement and one child's health statement not to have a statement as to when the next FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ visit is required. Correction: Obtain a current health statement for all children whose have expired or missing, with a statement as to when the next visit is required. Correct and submit written statement of compliance with overall response by 2/23/25. Correct by 02/23/2025

Corrected Corrected by Feb 23, 2025

Category: ratio. 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 4 children's files and observed one child to have an expired emergency medical authorization. Correction: Obtain current emergency medical authorization for all children in care. Correct immediately by 1/23/25 or on next day child is in care and submit written statement of compliance with overall response by 2/23/25. Correct by 01/23/2025

Corrected Corrected by Jan 23, 2025

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

2.219.B.1 · At the time of admission, the parent(s)/guardian(s) must provide for each child entering the center: Documentation of school-required immunization status or certificate of medical or nonmedical exemption, is required by FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ 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 certificate of immunization or on an “approved alternate” Certificate of Immunization, defined in Colorado Department of Public Health and Environment rules located in 6 CCR 1009-2 rule section 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., Bldg. C, Denver, CO 80246, during regular business hours. Colorado law requires proof of immunization status or exemption be provided prior to or on the first day of admission.

Reviewed 4 children's files and observed one child's immunization not to be on the Department approved form. Correction: All children's immunizations must be on the Department approved form. Correct immediately by 1/23/25 and submit written statement of compliance with overall response by 2/23/25. Correct by 01/23/2025

Corrected Corrected by Jan 23, 2025

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

2.209.A.3 · 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: Names, addresses, and telephone numbers of persons authorized to pick up the child from the center.

Observed the facility's admission record to be missing the name, address and phone number of persons authorized to pick up children from the center. Correction: Obtain name, address and phone number of persons authorized to pick up children from the center on facility's admission record. Correct immediately by 1/23/25 or on next day child is in care and submit written statement of compliance with overall response by 2/23/25. Correct by 01/23/2025

Corrected Corrected by Jan 23, 2025

Category: recordkeeping. Marked corrected in the state record.

2.229.H · Sharp tools and instruments must be stored in areas inaccessible to children.

Observed a pair of adult scissors on the teacher's desk in the Hungry Caterpillar room, accessible to children. Correction: Sharp tools must be stored in ares inaccessible to children. Correct immediately by 1/23/25. Corrected at the time of visit by the Director putting the scissors in a locked cabinet. No written response is required. Correct by

Open Not marked corrected in the state record

Open / not marked corrected.

2.127.D · All facilities, except family child care homes must post in every room of the child care facility, excluding bedrooms and living areas, the license capacity of the room and the staff-to-child ratio required by regulation to be maintained for the age of children cared for in the room.

Observed the Brown Bear, Brown Bear and Llama, Llama classroom to be missing staff to child ratio postings. Correction: Post staff to child ratios in the classrooms missing them. Correct immediately by 1/23/25. Corrected at the time of visit by the Director posting the ratios and capacities of the classrooms. No written response is required. Correct by 01/23/2025

Corrected Corrected by Jan 23, 2025

Category: ratio. 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 a random sampling of 5 children's files and observed one child to not have a signed and dated emergency medical authorization. Correction: Obtain a signed and dated emergency medical authorization for all children in care. Correct immediately by 2/27/2024 or on next day child is in care. Submit written statement of compliance with overall response by 3/27/2024. Correct by 02/27/2024

Corrected Corrected by Feb 27, 2024

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

2.213.I · Within ninety (90) calendar days of employment, all staff required to register with the Colorado Shines Professional Development Information System (listed in rule section 2.208(D)) must complete the Department-approved Recognizing the Impact of Bias on Early Childhood Professionals training or other Department-approved training on implicit bias. This course is required once and will be counted towards ongoing professional development.

Reviewed 8 staff files and observed one staff, C Santillan (DOH 5/10/23) to be missing documentation of a Department approved Recognizing the Impact of Bias training within 90 days of hire. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ Correction: Obtain documentation of a Department approved Recognizing the Impact of Bias training for the staff member listed above. Correct and submit written statement of compliance with overall response by 3/27/2024. Correct by 03/27/2024

Corrected Corrected by Mar 27, 2024

Category: recordkeeping. Marked corrected in the state record.

2.213.F · Within thirty (30) calendar days of employment, all employees caring for children, not required by rule to be certified in First Aid and CPR, must complete the Department-approved Introduction to First Aid and CPR module. The module must be renewed every two (2) years.

Reviewed 8 staff files and observed one staff, S Ruff (DOH 10/17/22) to be missing documentation of a Department approved First Aid and CPR module training within 30 days of hire. Correction: Obtain documentation of a Department approved First Aid and CPR module for the staff member listed above. Correct immediately by 2/27/24 and submit written statement of compliance with overall response by 3/27/2024. Correct by 02/27/2024

Corrected Corrected by Feb 27, 2024

Category: recordkeeping. Marked corrected in the state record.

2.216.B.1.e · There must be at least one (1) staff member on duty in each infant room at all times who holds a current Department-approved first aid and safety certificate that includes cardiopulmonary resuscitation (CPR) for all ages of children.

Reviewed 8 staff files and observed the staff member in the infant room, C Santillan, to be missing documentation of a Department approved First Aid and CPR certification. Correction: There must be at least one staff member on duty in each infant room at all times that holds a current Department approved First Aid and CPR certification. Correct immediately by 2/27/24 and submit written statement of compliance with overall response by 3/27/2024. Correct by 02/27/2024

Corrected Corrected by Feb 27, 2024

Marked corrected in the state record.

2.216.B.2.a · In the infant program, there must be a qualified infant program supervisor present sixty percent (60%) of the hours of operation of the infant program who is responsible for the care of the infants. An individual qualified as an infant early childhood teacher must be responsible during the remaining time.

Reviewed 8 staff files and observed the staff member in the infant room, C Santillan, to be missing documentation of INS qualifications and the INS staff member, M Lindblad, to be scheduled in the room after 1pm every day. Correction: There must be a qualified IPS present 60% of the hours of operation of the infant program who is responsible for the care of the infants. Correct immediately by 2/27/24 and submit written statement of compliance with overall response by 3/27/2024. Correct by 02/27/2024

Corrected Corrected by Feb 27, 2024

Category: supervision. Marked corrected in the state record.

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.

Reviewed 8 staff files and observed one staff, S Ruff (DOH 10/17/22) to have an expired (2/22/24) Shaken Baby training and to be working in a toddler room. Correction: Obtain documentation of a Department approved Shaken Baby training for the staff member listed above. Correct immediately by 2/27/24 and submit written statement of compliance with overall response by 3/27/2024. Correct by 02/27/2024

Corrected Corrected by Feb 27, 2024

Category: recordkeeping. 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 8 staff files and observed one staff, S Ruff (DOH 10/17/22) to have an expired (2/21/24) Standard Precautions training prior to working with children. Correction: Obtain documentation of a Department approved Standard Precautions training for the staff member listed

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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 site director must be trained in the Department approved training.

Reviewed 8 staff files and observed two staff, H White (DOH 10/24/23) and Christa E (DOH 8/28/23) to be missing documentation of a Department approved Emergency and Disaster Prep training prior to working with children. Correction: Obtain documentation of a Department approved Emergency and Disaster Prep training for the staff members listed above. Correct immediately by 2/27/24 and submit written statement of compliance with overall response by 3/27/2024. Correct by 02/27/2024

Corrected Corrected by Feb 27, 2024

Category: recordkeeping. Marked corrected in the state record.

2.222.A.1.b · All diaper change areas must: Have a place inaccessible to children for storing all diaper change supplies and disinfecting solutions and products;

Observed diaper changing supplies accessible to children in the preschool (Hungry Caterpillar) room. Correction: All diaper change areas must have a place inaccessible to children for storing all diaper change supplies and disinfecting solutions and products. Correct immediately by 2/27/24 and submit written statement with overall response by 3/27/24. Correct by 02/27/2024

Corrected Corrected by Feb 27, 2024

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 FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ care homes, and qualified exempt provider homes:

Reviewed 8 staff files and observed one staff member J Miller to be missing documentation of an out-of state 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 members J Miller has reviewed the powerpoint within 24 hours. Submit documentation of Out of State Clearance Letters for staff member J Miller with written response to specialist. Correct by 02/27/2024

Corrected Corrected by Feb 27, 2024

Category: supervision. Marked corrected in the state record.