2.220.D · Over-the-counter medication must be kept in the originally labeled container and be labeled with the child's first and last name.

Reviewed 9 children's medications and observed that 1 child's Zyrtec was missing their first and last name. Correction: Immediately, over the counter medication must be kept in the originally labeled container and be labeled with the child's first and last name. Corrected at the time of the visit. The assistant director labeled the medication with the child's first and last name. Submit a written statement of compliance by 3/14/2024. Correct by 03/07/2024

Corrected Corrected by Mar 7, 2024

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

2.220.J · If a medication is out of date or left over, the parent(s)/guardian(s) is responsible for picking up the medication. If the parent(s)/guardian(s) do not respond, the center must dispose of the medications as required by the Colorado Department of Public Health and Environment. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________

Reviewed 9 children's medications and observed that 1 child's Zyrtec was expired as of 2/2024 and not disposed of. Correction: Immediately, if medication is out of date the parents/guardians are responsible for picking up the medication. If they do not pick up the medication, it must be disposed of as required by CDPHE. Submit a written statement of compliance by 3/14/2024. Correct by 03/07/2024

Corrected Corrected by Mar 7, 2024

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

7.702.31.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 25 child files. Observed 1 child missing current documentation of a signed center's policies and procedures. Correction: Immediately, a center must obtain a signed document stating the parent(s)/guardian(s) have received the policies and procedures, at the time of enrollment and upon amendmens to policies and procedures. Submit a written statement of compliance by 12/20/2023. Correct by 12/06/2023

Corrected Corrected by Dec 6, 2023

Marked corrected in the state record.

7.702.34.A.7 · 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 25 child files. Observed 1 child missing current documentation of written authorization for FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ emergency medical care. Correction: Immediately, written authorization for emergency medical care must be signed and updated annually by the parent(s)/guardian(s). Submit a written statement of compliance by 12/20/2023. Correct by 12/06/2023

Corrected Corrected by Dec 6, 2023

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

7.702.51.A.2.a · 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 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. Colorado law requires proof of immunization status or exemption be provided prior to or on the first day of admission.

Reviewed 25 child files. Observed 1 child missing current documentation of immunization status. Correction: Immediately, the parent(s)/guardian(s) must provide up-to-date school-required immunizations as specified on the Colorado Department of Public Health and Environment Certificate of Immunization. Submit a written statement of compliance by 12/20/2023. Correct by 12/06/2023

Corrected Corrected by Dec 6, 2023

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

7.702.51.A.2.c · At the time of admission, the parent(s)/guardian(s) must provide for each child entering the center: Statements of health status of children less than two (2) years of age must be updated in accordance with the American Academy of Pediatrics recommended schedule for routine health supervision or as required in writing by the health care provider.

Reviewed 25 child files. Observed 1 child less than two (2) years of age missing a current health statement. Correction: Immediately, statementss of health status of children less than two (2) years of age must be updated in accordance with the American Academy of Pediatrics recommended schedule. Submit a written statement of compliance

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

7.702.51.A.2.d · At the time of admission, the parent(s)/guardian(s) must provide for each child entering the center: Health statements for children over two (2) years of age to seven (7) years of age must be updated in accordance with the American Academy of Pediatrics recommended schedule for routine well child exams.

Reviewed 25 child files. Observed 2 children over two (2) years of age to seven (7) years of age missing a current health statement. Correction: Immediately, health statements must be updated in accordance with the American Academy of Pediatrics recommended schedule. Submit a written statement of compliance by 12/20/2023. Correct by 12/06/2023

Corrected Corrected by Dec 6, 2023

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

7.702.51.B.11 · 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 25 child files. Observed 1 child missing current documentation of a written authorization to apply topical preparations. Correction: Immediately, topical preparations may be applied with written authorization from the parent(s)/guardian(s). Submit a written statement of compliance by 12/20/2023. Correct by 12/06/2023

Corrected Corrected by Dec 6, 2023

Category: ratio. Marked corrected in the state record.

7.702.66.A.2 · The center must obtain written permission from the parent(s)/guardian(s) for any transportation of their child(ren) while in care.

Reviewed 25 child files. Observed 1 child missing written permission for transportation. Correction: Immediately, written permission from the parent(s)/guardian(s) must be obtained for any transportation. Submit a written statement of compliance by 12/20/2023. Correct by 12/06/2023

Corrected Corrected by Dec 6, 2023

Category: transportation. Marked corrected in the state record.

7.702.34.A.8 · The admission record must include: Written authorization, obtained in advance of the event from a parent/guardian, for a child to participate in field trips or special activities, whether scheduled or unscheduled, whether walking or riding in an approved vehicle.

Reviewed 25 child files. Observed 1 child missing current documentation of written authorization to participate in field trips. Correction: Immediately, written authorization must be obtained from a parent/guardian for a child to participate in field trips. Submit a written statement of compliance by 12/20/2023. Correct by 12/06/2023

Corrected Corrected by Dec 6, 2023

Category: transportation. Marked corrected in the state record.

7.702.42.J · Within ninety (90) calendar days of employment, all Directors and Assistant Directors must complete the Department-approved training: Working with an Early Childhood Mental Health Consultant. This course is required once and will be counted towards ongoing professional development.

Reviewed 28 staff files and observed that the Assistant Director, Tabor P., did not have documentation of the Working with an Early Childhood Mental Health Consultant training. Correction: Within 30 days, all directors and assistant directors must complete the department-approved training Working with an Early Childhood Mental Health Consultant. This course is required once and will be counted towards ongoing professional development. Submit documentation and a written statement of compliance by 12/17/2023. Correct by 12/17/2023

Corrected Corrected by Dec 17, 2023

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

7.702.42.K · Within ninety (90) calendar days of employment, all Directors and Assistant Directors must complete the department-approved training: Introduction to Child Care Health Consultation. This course is required once FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ and will be counted towards ongoing professional development.

Reviewed 28 staff files and observed that the Assistant Director, Tabor P., did not have documentation of the Introduction to Child Care Health Consultation training. Correction: Within 30 days, all directors and assistant directors must complete the department-approved training Introduction to Child Care Health Consultation. This course is required once and will be counted towards ongoing professional development. Submit documentation and a written statement of compliance by 12/17/2023. Correct by 12/17/2023

Corrected Corrected by Dec 17, 2023

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

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

In the Conifer classroom, observed chairs stacked up causing a hazard for children. In the Prairie Dog classroom, observed chairs stacked up causing a hazard for children. Correction: Immediately, indoor and outdoor equipment, materials, and furnsihings must be sturdy, safe, and free of hazards. Corrected at the time of the visit. The teachers and director unstacked the chairs no longer causing a hazard for children. Submit a written statement of compliance by 11/9/2023. Correct by 10/26/2023

Corrected Corrected by Oct 26, 2023

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

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

At the time of the visit, in the Spruce classroom, observed Saline Solution labeled "keep out of reach of children" in an unlocked cabinet accessible to children. Correction: Immediately, items labeled "keep out of reach of children" must be inaccessible to children. Corrected at the

Open Not marked corrected in the state record

Open / not marked corrected.

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

At the time of the visit, in the Pikes Peak classroom and the Keystone classroom, observed adult scissors in an unlocked drawer or a low shelf accessible to children. Correction: Immediately, sharp tools and instruments must be stored in areas accessible to children. Corrected at the time of the visit. The teachers moved the scissors to a higher shelf making them inaccessible to children. Submit a written statement of compliance by 7/18/2023. Correct by 07/11/2023

Corrected Corrected by Jul 11, 2023

Marked corrected in the state record.

7.702.61.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.

At the time of the visit, in the Steamboat classroom and Breckenridge classroom, diapers and wipes on a low shelf accessible to children. Correction: Immediately, all diaper change areas must: have a place inaccessible for storing all diaper change supplies and disinfecting solutions and products. Corrected at the time of the visit. The teachers moved the diapers and wipes to a higher shelf making them inaccessible to children. Submit a written statement of compliance by 7/18/2023. Correct by 07/11/2023

Corrected Corrected by Jul 11, 2023

Marked corrected in the state record.

7.702.34.A.7 · 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.

At the time of the visit, reviewed 1 child file and observed that the emergency medical care authorization was expired. Correction: Immediately, the admission record must include: a dated, written authorization for emergency medical care

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

7.702.51.A.2.d · At the time of admission, the parent(s)/guardian(s) must provide for each child entering the center: Health statements for children over two (2) years of age to seven (7) years of age must be updated in accordance with the American Academy of Pediatrics recommended schedule for routine well child exams.

At the time of the visit, reviewed 1 child file and observed that they were missing documentation of a current health statement. Correction: Immediately, the parents/guardians must provide for each child entering the center: health statement for children over 2 years of age to 7 years of age must be updated in accordance with the American Academy of Pediatrics recommended schedule for routine well exams. Submit a written statement of compliance by 7/18/2023. Correct by 07/11/2023

Corrected Corrected by Jul 11, 2023

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