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 must be completed every three (3) years and can be applied towards ongoing annual training hours in the year that it is completed;

Reviewed Provider's file and observed Medication Administration training expired (3/17/25) Correction: Obtain and maintain current and up to date Medication Administration training. Correct immediately 6/5/2025 and submit written compliance by 7/5/2025. Correct by 06/05/2025

Corrected Corrected by Jun 5, 2025

Category: ratio. 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 FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ reach of children.”

During safety walk through, observed items labeled "keep out of reach of children" in the bathroom and play area. (mouthwash, wipes, razor, bubbles, retainer cleaner, small screw driver, and hair product). Correction: Ensure all items labeled "keep out of reach of children" are inaccessible to children at all times. Correct immediately 6/5/2025 ***Corrected at time of visit. No response required. Correct by 06/05/2025

Corrected Corrected by Jun 5, 2025

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 to, paints, fuels, insecticides, and other hazardous chemicals.

During safety walk through, observed flammable items (paint cans, cardboard box, plastic box) stored next to the furnace and water heater. Correction: Ensure all flammable or combustible items are stored at least 3 feet from the furnace and water heater at all times. Correct immediately 6/5/2025 and submit written compliance by 7/5/2025. Correct by 06/05/2025

Corrected Corrected by Jun 5, 2025

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

2.312.M · Within ninety (90) calendar days of caring for children the primary provider, applicant 2, the equally qualified provider, qualified substitutes, and all staff must complete a Department-approved introduction to the early intervention and preschool special education programs. This course is required once and will be counted towards ongoing training requirements;

Reviewed Provider's file and observed Introduction to the Early Intervention and Preschool Special Education Programs training to be missing. Correction: Obtain and maintain documentation of Early Intervention and Preschool Special Education Programs training. Correct immediately 6/5/2025 and submit written compliance by 7/5/2025. Correct by 06/05/2025

Corrected Corrected by Jun 5, 2025

Category: recordkeeping. Marked corrected in the state record.

2.312.N · Within ninety (90) calendar days of caring for children the primary provider, applicant 2, the equally qualified provider, qualified substitutes, and all staff must complete a Department-approved training for recognizing the FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ impact of bias on early childhood professionals. This course is required once and will be counted towards ongoing training requirements;

Reviewed Provider's file and observed Recognizing the Impact of Bias on Early Childhood Professionals training to be missing. Correction: Obtain and maintain documentation of Recognizing the Impact of Bias on Early Childhood Professionals training. Correct immediately 6/5/2025 and submit written compliance by 7/5/2025. Correct by 06/05/2025

Corrected Corrected by Jun 5, 2025

Category: recordkeeping. Marked corrected in the state record.

2.311.A.14 · Subsequent health evaluations for the primary provider, applicant 2, and children residing in the home who are less than ten (10) years of age must be obtained every two (2) years or as required in a written plan signed by a licensed physician or other health care provider. A new family member and/or a new resident of the home must obtain a health evaluation form signed and dated by a licensed physician or other health care provider within thirty (30) days from the date the individual began living in the home.

Reviewed Provider's file and observed a current health statement to be missing. Correction: Obtain and maintain a current and up to date health statement. Correct and submit written compliance by 7/5/2025. Correct by 07/05/2025

Corrected Corrected by Jul 5, 2025

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

2.321.A.4 · Statements of health status of children less than two (2) years of age must be updated as required in writing by the health care provider, or in accordance with the American Academy of Pediatrics Recommendations for Preventive Pediatric Health Care recommended schedule at https://downloads.aap.org/AAP/PDF/periodicity_schedule.pdf,(4th ed. American Academy of Pediatrics, 2017) herein incorporated by reference. No later editions or amendments are incorporated. These recommendations are available at no cost from https://www.aap.org/. These recommendations are also available for public inspection and copying at the Colorado Department of Early Childhood, 710 S. Ash St., Denver, CO 80246, during regular business hours..

Reviewed 7 children files and observed 1 infant to have an expired health statement. Correction: Obtain and maintain current and up to date health statements for all children enrolled. Correct and submit written compliance by 7/5/2025. Correct by 07/05/2025

Corrected Corrected by Jul 5, 2025

Category: health medication. 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 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.

Emergency drills observed to be incomplete. Fire drills were not done in February and April. Tornado drills not done in April and May. No documentation of lock down drills were done this year 2025. Correction: Ensure fire drills are done monthly, tornado drills are done March-October, and lock down drills are done quarterly. Correct immediately 6/5/2025 and submit written compliance by 7/5/2025. Correct by 06/05/2025

Corrected Corrected by Jun 5, 2025

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.

Observed provider missing documentation of current safe sleep training. Correction: Obtain documentation of current safe sleep training. Correct immediately 7/3/2024 and respond by 8/2/2024. Correct by 07/03/2024

Corrected Corrected by Jul 3, 2024

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

2.312.J · Within thirty (30) calendar days of caring for children the primary provider and all individuals 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. This training must be renewed annually.

Observed provider missing documentation of current immunization training. Correction: Obtain documentation of current immunization training. Correct immediately 7/3/2024 and respond by 8/2/2024. Correct by 07/03/2024

Corrected Corrected by Jul 3, 2024

Category: health medication. 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.

Observed provider missing documentation of current standard precautions training. Correction: Obtain documentation of current standard precautions training. Correct immediately 7/3/2024 and respond by 8/2/2024. Correct by 07/03/2024

Corrected Corrected by Jul 3, 2024

Category: ratio. 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.

Observed provider missing documentation of current child abuse prevention training. Correction: Obtain documentation of current child abuse prevention training. Correct immediately 7/3/2024 and respond

Corrected Corrected by Jul 3, 2024

Category: recordkeeping. Marked corrected in the state record.

2.311.A.14 · Subsequent health evaluations for the primary provider, applicant 2, and children residing in the home who are less than ten (10) years of age must be obtained every two (2) years or as required in a written plan signed by a licensed physician or other health care provider. A new family member and/or a new resident of the home must obtain a health evaluation form signed and dated by a licensed physician or other health care provider within thirty (30) days from the date the individual began living in the home.

Observed provider and provider's child (under the age of 10), missing documentation of current health statement. Correction: Obtain documentation of current health statement. Correct by 08/02/2024

Corrected Corrected by Aug 2, 2024

Category: health medication. 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.

identified through discussion with provider that she needs to get an updated physical/health evaluation. Correction: Obtain documentation of current physical/health evaluation. Correct by 09/03/2023

Corrected Corrected by Sep 3, 2023

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

7.707.71.B.1 · The provider must obtain written authority to arrange for emergency medical care for each child. Written authorization to obtain emergency medical care must be on file prior to or on the first day of admission and must FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ be re-authorized annually.

Reviewed 6 children's files and observed 1 file with an expired written authority to arrange for emergency medical care. Correction: Obtain documentation of written authority to arrange for emergency medical care. Correct immediately 8/4/2023 and respond by 9/3/2023. Correct by 08/04/2023

Corrected Corrected by Aug 4, 2023

Marked corrected in the state record.

7.707.921.H · Stairways of more than four (4) steps that are accessible to children must have gates that prevent access from the area being used when children under two (2) years old are present. The gate may be taken down as long as the provider is providing direct supervision of the child who is learning climbing skills on the stairs. Because of the risk of serious physical injury to a child, providers, employees, substitutes, volunteers, and visitors must never lift children over the gates while on a stairway.

Observed that the stairway has a gate at the top of the stairs but not one at the bottom preventing children under age 2 from accessing the area. Correction: Stairways of more than 4 steps that are accessible to children must have gates that prevent access from the area being used when children under 2 are present. Correct immediately 8/4/2023 and respond by 9/3/2023. Correct by 08/04/2023

Corrected Corrected by Aug 4, 2023

Category: supervision. Marked corrected in the state record.