2.220.A · Any unexpired routine medication, prescription or non-prescription (over the counter), must be administered only with a current written order of a health care provider with prescriptive authority and with written parental consent. Home remedies, homeopathic medication, vitamins, and supplements must not be administered to children in child care.

Observed an Epi pen in the Teddy Bear classroom with a health care plan lacking parent signature. Correction: All medication must be administered only with a current written order of a health care provider and with written parental consent. Correct by 08/07/2024

Corrected Corrected by Aug 7, 2024

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 21 staff files and observed Vanessa to be lacking a medical statement from the doctor. Correction: All staff must submit to the center a medical statement, signed and dated by a health care provider.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

2.208.A.2 · The following records must be on file at the center: A list of current staff members, substitutes, and staffing patterns;

Observed the facility to not be documenting when each staff member enters or exits a classroom. Correction: Staffing patterns must be available for review. Staff must be signing into and out of a classroom each time it is entered and exited. Correct by 08/07/2024

Corrected Corrected by Aug 7, 2024

Category: recordkeeping. 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.

Observed the Polar Bears class to be outside at the time of inspection. There were 10 children outside on the playground but the classroom name-to-face showed 12 children. Correction: Staff members must complete written attendance verification periodically throughout the day, including during transitions. Correct by 08/07/2024

Corrected Corrected by Aug 7, 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 21 staff files and observed Savannah and Samantha to have an expired standard precautions training. Correction: All staff must complete a standard precautions training prior to working with children. This training must be renewed annually. Correct by 08/07/2024

Corrected Corrected by Aug 7, 2024

Category: recordkeeping. Marked corrected in the state record.

2.213.C · Staff working with infants less than twelve (12) months old must complete a Department-approved FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ 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.

Reviewed 21 staff files and observed Savannah, Samantha, and Crystele to have an expired safe sleep training. Correction: Staff working with infants less than 12 months old must complete safe sleep training prior to working with infants less than 12 months old. Correct by 08/07/2024

Corrected Corrected by Aug 7, 2024

Category: physical safety. 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 21 staff files and observed Samantha to have an expired shaken baby training. Correction: Staff working with children less than 3 years old must complete the shaken baby/abusive head trauma training prior to working with children under 3. Correct by 08/07/2024

Corrected Corrected by Aug 7, 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 21 staff files and observed Samantha, Savannah and Crystele to have an expired child abuse prevention training. Correction: All employees must be trained about child abuse prevention and this training must be renewed annually. Correct by 08/07/2024

Corrected Corrected by Aug 7, 2024

Category: recordkeeping. Marked corrected in the state record.

2.213.N · Within thirty (30) calendar days of employment and annually, all staff responsible for the collection, review, and maintenance of the child immunizations records must complete the Colorado Department of Public Health and Environment immunization course. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________

Reviewed 21 staff files and observed Samantha to have an expired immunization training. Correction: All staff responsible for the collection, review, and maintenance of the child immunization records must complete the CDPHE immunization course annually. Correct by 08/07/2024

Corrected Corrected by Aug 7, 2024

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

2.223.C.8 · Other sleep equipment not manufactured for commercial use is prohibited.

Observed a sleep sack with a weighted chest in the Teddy Bears classroom. Infant was not sleeping in the sleep sack at the time of inspection. Correction: Sleep equipment not manufactured for commercial use is prohibited. Weighted sleep sacks are not safe for infants. ***Corrected at the time of inspection. Director removed sleep sack. No response required. Correct by 08/07/2024

Corrected Corrected by Aug 7, 2024

Category: physical safety. 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 21 staff files and observed Sarah to have an expired CPR/ first aid training and lacking the basic first aid/CPR module. Correction: All employees not required by rule to be certified in first aid and CPR must complete the Introduction to first aid and CPR module. Correct by 09/07/2024

Corrected Corrected by Sep 7, 2024

Category: recordkeeping. Marked corrected in the state record.

2.133.B · Each staff member of the facility must be trained in fire safety and the use of available fire extinguishers and fire alarms

Reviewed 21 staff files and observed all to be lacking a training on fire safety and the use of available extinguishers and fire alarms. Correction: Each staff member of the facility must be trained in fire safety and the use of available fire extinguishers and fire alarms. Correct by 08/07/2024

Corrected Corrected by Aug 7, 2024

Category: recordkeeping. 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.

Reviewed the facilities drill log and observed it to be lacking a record of a Tornado drill held for May 2024. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ Correction: A record of all emergency drills held over the past 12 months must be maintained by the facility. Correct by 09/07/2024

Corrected Corrected by Sep 7, 2024

Category: recordkeeping. Marked corrected in the state record.

2.121.J.1.a · 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: State criminal history check

Reviewed 21 staff files and observed Krista to have lived out of state within the last 5 years and lacking out of state background clearance. Facility had not submitted for out of state criminal check. Correction: Background checks must be submitted and successfully completed for each state an individual has resided in prior to an individual caring for children or allowing the individual unsupervised access to children. Correct by 08/07/2024

Corrected Corrected by Aug 7, 2024

Category: supervision. Marked corrected in the state record.

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

Observed a bag of potting soil labeled "keep out of reach of children", accessible to children in a bin on a low shelf in the Brown Bears classroom. Correction: Items labeled "keep out of reach of children" must be inaccessible to children at all times. ***Corrected at the time of inspection. Director removed bag from the classroom. No response required. Correct by 08/07/2024

Corrected Corrected by Aug 7, 2024

Marked corrected in the state record.

2.217.C.4 · The date and content of each consultation must be recorded and maintained in the center's files for three (3) years.

Reviewed the facilities nurse information and observed it to be lacking notes from each consultation. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ Correction: The date and content of each consultation must be recorded and maintained in the center's files for 3 years. Correct by 09/07/2024

Corrected Corrected by Sep 7, 2024

Category: recordkeeping. 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.

Observed an expired Benedryl in the Polar Bears classroom. Correction: If a medication is out of date, the parents are responsible for picking up the medication or the center must dispose of the medication as required by CDPHE. Correct by 08/07/2024

Corrected Corrected by Aug 7, 2024

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

2.223.C.17 · If music is played in the infant sleep area, the music must not be played at a loud volume that would prevent infants from being heard by staff. Music equipment must not be placed under a crib or within three (3) feet of the sleeping infant.

Observed 2 sound machines in the infant room (Cubs) that were less than 3 feet from the cribs. Correction: Music equipment must not be placed under a crib or within 3 feet of the sleeping infant. Correct by 08/07/2024

Corrected Corrected by Aug 7, 2024

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

2.223.C.2.a · Mattresses for cribs and futons must have a properly fitted, clean sheet.

Observed a loose fitting crib sheet in the infant classroom (Cubs). There was no sleeping infant in the crib at the time of inspection. Correction: Mattresses for cribs must have a properly fitted, clean sheet. Correct by 08/07/2024

Corrected Corrected by Aug 7, 2024

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

7.702.51.B.10 · 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.

Observed a health care plan in the Grizzley's classroom with expired provider and parent signatures. Correction: If a medication is out of date or left over, the parents are responsible for picking up the medication. If the parents do not respond, the center must dispose of the medications as required by CDPHE. Correct by 08/16/2023

Corrected Corrected by Aug 16, 2023

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

7.702.42.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 18 staff files and observed Gloria H. and Elena R. to have an expired shaken baby training. Correction: Staff working with children under the age of 3 must complete Prevention of Shaken Baby/Abusive Head Trauma training. This training must be renewed every 2 years. Correct by 08/16/2023

Corrected Corrected by Aug 16, 2023

Category: recordkeeping. Marked corrected in the state record.

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

Observed a Dawn dish soap and a hand soap labeled "keep out of reach of children" on the counter FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ accessible to children in the Grizzley's classroom. Correction: Items labeled "keep out of reach of children" must be inaccessible to children. ***Corrected at the time of inspection. Director moved items to locked cabinet. No response required. Correct by 08/16/2023

Corrected Corrected by Aug 16, 2023

Marked corrected in the state record.

7.701.34.A · . Prior to the original license being issued, following the renovation of the facility that would affect the licensing of the facility and at least every two (2) years thereafter, all child care facilities except family child care homes and Neighborhood Youth Organizations must be inspected and obtain an approving inspection report from the local department of health or the Colorado Department of Public Health and Environment and from the local fire department. These reports must be maintained at the facility and be available for review upon request by a Licensing Specialist.

Observed the facility to have an expired fire inspection. Correction: Prior to the original license being issued, following the renovation of the facility and at least every 2 years thereafter, all child care facilities must be inspected and obtain an approving inspection from the local fire department. Correct by 09/16/2023

Corrected Corrected by Sep 16, 2023

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

7.701.100.F.2 · . 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.

Reviewed facilities drill log and observed it to be lacking a record of a tornado drill held in July of 2023, lacking a record of all (4) lockdown drills for the past 12 months, and lacking a record of a fire drill held in November and December of 2022. Correction: A record of all emergency drills held over the past 12 months must be maintained by the facility. Correct by

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

7.702.46.A.15 · Maximum Group Size for Children by AGES OF CHILDREN and MAXIMUM GROUP SIZE: 6 weeks to 18 months: 10 infants 12 months to 36 months: 10 toddlers 24 months to 36 months: 14 toddlers 2-1/2 years to 3 years: 16 children 3 years to 4 years: 20 children 4 years to 5 years: 24 children 5 years and older: 30 Children Mixed age group 2-1/2 to 6 years of age: 20 Children

Observed 17 1 year olds (Koala's) on the toddler playground at the time of inspection. Correction: Ensure that maximum group size is never exceeded. Correct by 08/16/2023

Corrected Corrected by Aug 16, 2023

Category: ratio. Marked corrected in the state record.

7.702.42.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 18 staff files and observed Alice B. and Elena R. to have an expired child abuse prevention training. Correction: Within 30 days of employment, all employees must be trained using a department approved training about child abuse prevention. ***Alice B. corrected violation at the time of inspection. Teacher completed training. Response only required for Elena R. Correct by 08/16/2023

Corrected Corrected by Aug 16, 2023

Category: recordkeeping. Marked corrected in the state record.

7.702.42.I · Within ninety (90) calendar days of employment, all staff required to register with the Colorado Shines Professional Development Information System (listed in Section 7.702.33, 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 18 staff files and observed Savannah H. to be lacking the Recognizing the Impact of Bias on Early FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ Childhood Professionals training. Correction: Within 90 days of employment, all staff must complete the department approved Recognizing the Impact of Bias training. Correct by 09/16/2023

Corrected Corrected by Sep 16, 2023

Category: recordkeeping. Marked corrected in the state record.

7.702.42.M · Within thirty (30) calendar days of employment and annually, all staff responsible for the collection, review, and maintenance of the child immunizations records must complete the Colorado Department of Public Health and Environment immunization course.

Reviewed 18 staff files and observed Nina to have an expired immunization training. Correction: Within 30 calendar days of employment and annually, all staff responsible for the collection, review, and maintenance of the child immunization records must complete the CDPHE immunization course. Correct by 08/16/2023

Corrected Corrected by Aug 16, 2023

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

7.702.42.B · All staff must complete a Department-approved Standard Precautions training that meets current Occupational Safety and Health Administration (OSHA) requirements prior to working with children. This training must be renewed annually and will be counted towards ongoing professional development.

Reviewed 18 staff files and observed Elena R. to have an expired standard precautions training. Correction: All staff must complete a Standard Precautions training that meets current OSHA requirements prior to working with children. Correct by 08/16/2023

Corrected Corrected by Aug 16, 2023

Category: ratio. Marked corrected in the state record.

7.702.41.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 18 staff files and observed Celia R. and Briceida N. to be lacking a medical statement from a health care provider. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ Correction: All staff members must submit to the center a medical statement signed and dated by a health care professional within 30 days after the first day of employment. Correct by 09/16/2023

Corrected Corrected by Sep 16, 2023

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