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

In the infant room, observed two cribs fitted with a loose, bunched up sheet. Identified through Assistant Director Joey's statement that neither of the cribs had been in use yet today. Correction: Ensure cribs have a properly fitted sheet. **Corrected at the time of visit. AD Joey changed the sheets to properly fitting ones.** No response required. Correct by 10/14/2024

Corrected Corrected by Oct 14, 2024

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 FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ program at all times who has a current Department-approved first aid and safety certificate that includes (CPR) for all ages of children.

Reviewed eleven staff files and identified the program did not have a staff member working in the toddler program at the time of visit who has a current Department-approved CPR and First Aid certificate. This is a direct violation of stipulation (J) on the probationary license. Probationary stipulation (J) states “Staff members must complete any trainings required for their assigned position prior to being placed in the classroom and/or per timelines as prescribed in rule. This may include, but may not be limited to: training and orientation in facility policies and procedures, standard precautions, CPR and first aid, safe sleep, shaken baby/abusive head trauma prevention and medication administration. Verification of completed training must be available for review at all times.” Correction: Ensure that for every fifteen or fewer toddlers, there is at least one staff member in the toddler program at all times who has a current Department-approved CPR and First Aid certificate. Correct immediately and respond with a plan for ongoing compliance by 10/17/24. Correct by 09/17/2024

Corrected Corrected by Sep 17, 2024

Category: ratio. Marked corrected in the state record.

2.220.B.2 · The written order by the person with prescriptive authority shall include: Licensed prescribing practitioner name, telephone number, and signature.

Reviewed two health care plans and identified one health care plan not signed by the licensed prescribing practitioner. Correction: Obtain licensed prescribing practitioner's signature. Correct immediately and respond with a statement of compliance by 10/17/24. Correct by 09/17/2024

Corrected Corrected by Sep 17, 2024

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

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.

Reviewed two health care plans and identified both health care plans were not signed by the parents. Correction: Obtain written parental consent to administer medication. Correct immediately and respond with a statement of compliance by 10/17/24. Correct by 09/17/2024

Corrected Corrected by Sep 17, 2024

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

2.218.C.4 · For an enrolled child with a newly identified special health care need, the center must obtain written instructions for providing services from the child's parent(s)/guardian(s) and the health care provider. If the child with FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ special health care needs does not have an existing individualized health care plan, the individualized health care plan and all associated medication(s) and/or equipment must be provided within thirty (30) calendar days of the child's identified need.

Reviewed two health care plans and identified one health care plan dated over thirty days ago indicating a prescribed emergency medication that was not available on site at the program. Correction: Obtain all required medications indicated on health care plans within thirty days of the child's identified need. Correct immediately and respond with a statement of compliance by 10/17/24. Correct by 09/17/2024

Corrected Corrected by Sep 17, 2024

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

2.206.B · The written policies and procedures must be developed, implemented, and followed, and must include at a minimum the following information:

Reviewed the program's policies and procedures and identified the following policies to be missing or insufficient: B 4, 11, 18, 20, 23, 25, 26, and 29. Correction: Ensure the policies and procedures are developed, implemented, and followed and include at minimum the information specified in 2.206.B.1-30. Correct and respond with verification of compliance by 10/17/24. Correct by 10/17/2024

Corrected Corrected by Oct 17, 2024

Marked corrected in the state record.

2.217.A.14 · Staff to Child Ratios by ages of children and number of staff- 6 weeks to 18 months (infants):1 staff member to 5 infants; 12 months to 36 months: 1 staff member to 5 toddlers; 24 months to 36 months: 1 staff member to 7 toddlers; 2-1/2 years to 3 years:1 staff member to 8 children; 3 years to 4 years: 1 staff member to 10 children; 4 years to 5 years: 1 staff member to 12 children; 5 years and older: 1 staff member to 15 children; Mixed-age group 2-1/2 yrs to 6 yrs: 1 staff member to 10 children.

Licensing specialist requested the attendance records for the Toddler 1 room for the following dates: 4/18/24, 4/22/24, 4/24/24, and 5/9/24. Identified that on 4/22/24, there was one ECT with seven toddlers (1:7) at nap time from 12:30-1:30pm. The ratio for this toddler age group is 1:5. Identified that on 5/9/24, there was one ECT with eight toddlers (1:8) at nap time from 12:40-2:10pm. The ratio for this toddler age group is 1:5. This is a direct violation of stipulation B on the probationary license. Probationary stipulation B states, "Licensee shall FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ comply with required staff-to-child ratios and required maximum group sizes at all times. Ratios and room capacities must be posted in each classroom." Correction: Ensure required staff to child ratios are followed at all times. **Corrected at the time of visit--all classrooms were observed to be operating within required staff to child ratios.** Respond with a plan for ongoing compliance by 9/11/24. Correct by 09/04/2024 Stage II Licensing Concern : IPS is not present in the Infant program for sixty percent (60%) of each day that the center is operating. - FOUNDED

Corrected Corrected by Sep 4, 2024

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 FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ (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.

Licensing specialist requested attendance records for the Infant room for the following dates: 4/18/24, 4/24/24, and 5/9/24. Identified that on 4/18/24, the infant program supervisor was working in the Toddler 1 classroom and there was not a staff member meeting infant program supervisor qualifications in the infant room for sixty percent of that day. A qualified infant ECT was covering in the infant room on 4/18/24. This is a direct violation of stipulation C on the probationary license. Probationary stipulation C states, "All children must be under the direct and active supervision of qualified staff at all times, both indoors and outside. There must be at least one qualified Early Childhood Teacher supervising each group of children unless otherwise specified in rules." Correction: Ensure there is a qualified infant program supervisor present sixty percent of the hours of operation of the infant program who is responsible for the care of the infants. **Corrected at the time of visit--there was a qualified infant program supervisor working in the infant room who had been there sixty percent of the day.** Respond with a plan for ongoing compliance by 9/11/24. Correct by 09/04/2024 ________________________________________________ Stage II Licensing Concern : Program does not notify parents of incidents/injuries per program's policy. - UNFOUNDED Stage II Licensing Concern : Staff used harsh treatment with Ch2. - UNFOUNDED Stage II Licensing Concern : Staff did not provide supervision consistent with Ch2's needs. - UNFOUNDED ________________________________________________

Corrected Corrected by Sep 4, 2024

Category: supervision. Marked corrected in the state record.

2.122.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.

The fire inspection report states "inspection failed." Correction: Obtain an approving fire inspection report. Correct immediately and respond with verification of compliance by 7/4/24. Correct by 06/27/2024

Corrected Corrected by Jun 27, 2024

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

2.221.A · The center must obtain written authorization and instructions from the parent(s)/guardian(s) for the application of sunscreen or the use of another form of parent(s)/guardian(s) approved sun protection with a full-spectrum ultraviolet A/ ultraviolet B (UVA/UVB) rating of sun protection factor (SPF) thirty (30) or greater to their children's exposed skin prior to outside play year-round. a doctor's permission is not needed to use sunscreen at the center.

Reviewed 5 child files and identified 2 files missing signed sunscreen authorizations. Identified sunscreen authorizations state parents/guardians must provide sunscreen with a rating of at least 15 SPF. Correction: Obtain signed sunscreen authorizations and ensure these are on file for all children. Ensure sunscreen provided by parents/guardians has a rating of at least 30 SPF. Correct immediately and respond with a statement of compliance by 6/10/24. Correct by 06/03/2024

Corrected Corrected by Jun 3, 2024

Marked corrected in the state record.

2.221.D · If sunscreen is provided by the center, parent(s)/guardian(s) must be notified in advance, in writing, of the type of sunscreen the center will use.

Identified through the Director's statement that the center provides sunscreen for children who do not bring their own. Identified through sunscreen authorization forms and Director's statement that parents/guardians are not notified in advance, in writing, of the type of sunscreen the center will use. Correction: Ensure parents/guardians are notified in advance, in writing, of the type of sunscreen the center will use. Correct immediately and respond with a plan for ongoing compliance by 6/10/24. Correct by 06/03/2024

Corrected Corrected by Jun 3, 2024

Marked corrected in the state record.

2.224.B.2 · All infants less than six (6) months of age must be held for bottle feeding. Bottles must not be propped. Older infants must not be allowed to hold their own bottles when lying flat. Bottles must not be allowed in a crib with the infant.

An infant less than 6 months of age was laying on a boppy for a bottle feeding and not being held. Correction: All infants less than 6 months of age must be held for bottle feedings. Correct immediately and respond with statement of compliance. Correct by 03/11/2024

Corrected Corrected by Mar 11, 2024

Marked corrected in the state record.

2.237.B · Buildings must be kept in good repair and maintained in a safe condition.

In the Toddler classroom, there is a 2 inch hole in the half wall creating a hazard. Correction: Buildings must be kept in good repair. Correct immediately and respond with statement of compliance. Correct by 01/19/2024

Corrected Corrected by Jan 19, 2024

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

7.702.41.A · All staff at the center must demonstrate knowledgeable decision-making, judgment, and concern for the proper care and well-being of children.

In the preschool classroom, Specialist asked Staff member 1 how many children they had and they responded there were 10 children. Specialist only counted 9 children in the classroom. Correction: All staff must be knowledgeable about the number of children in their care at all times. Correct immediately and respond with statement of compliance. Correct by 12/01/2023

Corrected Corrected by Dec 1, 2023

Marked corrected in the state record.

7.702.64.B · Children must not be subjected to physical or emotional harm, humiliation, or threats.

Identified through staff statements that a staff member pulled a child by the arm to move them from under a table. Correction: Children must not be subject to physical harm. Correct immediately and respond with a statement of compliance. Correct by 12/01/2023 Stage II Licensing Concern : Staff members yell at children. - FOUNDED

Corrected Corrected by Dec 1, 2023

Marked corrected in the state record.

7.702.64.A · Guidance used at the center must be appropriate to the development of the child and is used as an opportunity to teach children social-emotional skills, such as self-regulation, problem-solving, and empathy for others.

Identified through staff statements that they have heard a staff member yelling at children. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ Correction: Guidance used at the center must be appropriate. Correct immediately and respond with statement of compliance. Correct by 12/01/2023 ________________________________________________ Stage II Licensing Concern : Children are not being served appropriate meals or given enough food. - UNFOUNDED Stage II Licensing Concern : Staff do not respond to crying children. - UNFOUNDED Stage II Licensing Concern : Staff leave their own food and drinks in areas that are accessible to children. - UNFOUNDED ________________________________________________

Corrected Corrected by Dec 1, 2023

Marked corrected in the state record.

7.702.41.A · All staff at the center must demonstrate knowledgeable decision-making, judgment, and concern for the proper care and well-being of children.

Identified through staff statements that staff were asking children if they knew how to swim without verifying their ability. Correction: Staff must demonstrate knowledgeable decision making when working with children, Correct immediately and respond with statement of compliance by 10/18/23. Correct by 10/11/2023 Stage II Licensing Concern : Program does not have a current Individualized care plan for CH1. - FOUNDED

Corrected Corrected by Oct 11, 2023

Marked corrected in the state record.

7.702.5.C.5 · The individual health care plan must be updated at least every twelve (12) months from the date of the initial plan and as changes occur. The plan must include all information needed to care for the child, must be signed by the health care provider, parent(s)/guardian(s) and must include, but not be limited to, the following:

Reviewed CH1's file and found a care plan that was more than 12 months old. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ Correction: Individual care plans must be updated every 12 months. Correct immediately and respond with statement of compliance by 10/18/23. Correct by 10/11/2023 Stage II Licensing Concern : Staff did not see CH1 jump into the deep end of the pool. CH1 did notknow how to swim. - FOUNDED

Corrected Corrected by Oct 11, 2023

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

7.702.62.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 staff statement that staff did not see CH1 jump into the deep end of the pool, creating a hazardous situation. CH1 could not swim. Correction: All children must be under direct supervision at all times. Correct immediately and respond with statement of compliance by 10/18/23. Correct by 10/11/2023 Stage II Licensing Concern : Staff did not apply/re-apply sunscreen as directed. - FOUNDED

Corrected Corrected by Oct 11, 2023

Category: supervision. Marked corrected in the state record.

7.702.51.C.2 · 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.

Identified through staff statements that sunscreen was not applied to all areas that would be exposed to the sun, and was not reapplied as directed, causing children to have sunburn. Correction: Sunscreen must be applied to all exposed areas prior to going outside, and reapplied as directed. Correct immediately and respond with statement of compliance by 10/18/23. Correct by 10/11/2023 ________________________________________________ Stage II Licensing Concern :

Corrected Corrected by Oct 11, 2023

Marked corrected in the state record.

7.702.62.D.5.a · If preschool-age children are in care for longer than five (5) hours, the center must provide at least a thirty (30) minute rest period meeting the following: A firm cot or two (2) inch mat with a sheet and blanket, or other suitable covering, must be provided for each child.

In the Preschool room, one child did not have a sheet on their cot. Correction: Sheets must be provided for each child. Correct immediately and respond with statement of compliance by 10/18/23. Correct by 10/11/2023

Corrected Corrected by Oct 11, 2023

Marked corrected in the state record.

7.702.62.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 staff statement that they did not see the incident that caused an injury to CH1. Correction: All children must be under direct supervision at all times. Correct immediately and respond with a statement of compliance by 8/22/23. Correct by 08/15/2023 ________________________________________________ Stage II Licensing Concern : There is a crack on the playground creating a hazard. - UNFOUNDED Stage II Licensing Concern : Staff did not call parents or write an injury report regarding an injury to a child. - UNFOUNDED ________________________________________________

Corrected Corrected by Aug 15, 2023

Category: supervision. Marked corrected in the state record.

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

In the Teacher Boat area in the front entrance there were two bottles of sunscreen labeled "keep out of reach of children" that were on a shelf accessible to children. Correction: Items labeled "keep out of reach of children" must be inaccessible to children. **Corrected at the time of the visit, Director moved sunscreen out of reach.** No response is required. Correct by 07/17/2023

Corrected Corrected by Jul 17, 2023

Marked corrected in the state record.

7.702.51.B.4 · Over-the-counter medication must be kept in the originally labeled container and be labeled with the child's first and last name.

In the Infant classroom, there were diaper creams that were not labeled with the child's first and last name. Correction: Over the counter medications must be labeled with the child's first and last name. Correct immediately and respond with statement of compliance by 8/17/23. Correct by 07/17/2023

Corrected Corrected by Jul 17, 2023

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

7.702.51.A.2.b · At the time of admission, the parent(s)/guardian(s) must provide for each child entering the center: 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 child files and found 2 children to have expired health statements. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ Correction: Within 30 days of enrollment and 30 days of expiration, all enrolled children must have a current health statement on file. Correct and respond with statement of compliance by 8/17/23. Correct by 08/17/2023

Corrected Corrected by Aug 17, 2023

Category: ratio. 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.

The programs drill record was not available for review. Correction: A record of all drills held must be maintained by the facility. Correct immediately and respond with statement of compliance by 8/17/23. Correct by 07/17/2023

Corrected Corrected by Jul 17, 2023

Category: recordkeeping. 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 FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ 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.

The program's health and fire inspections were in progress but non approving. Correction: Obtain approving health and fire statements. Correct immediately and respond with documentation of compliance by 8/17/23. Correct by 07/17/2023

Corrected Corrected by Jul 17, 2023

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

7.702.72.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.

The base of the red slide on the Preschool playground had only 3 inches of resilient surfacing (woodchips.) Correction: All climbing equipment 18 inches or higher must have resilient surfacing that is at least 6 inches in depth. Correct immediately and respond with a statement of compliance by 8/17/23. Correct by 08/17/2023

Corrected Corrected by Aug 17, 2023

Category: physical safety. 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 11 staff files and found Morgan, Roxanne and Alexandra to be missing medical statements. Correction: All staff must submit a medical statement within 30 days of employment. Correct and submit statement of compliance by 8/17/23. Correct by 08/17/2023

Corrected Corrected by Aug 17, 2023

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

7.702.66.C.2 · All drivers of vehicles owned or leased by the center in which children are transported must have a current Department-approved First Aid and Safety certificate that includes CPR for all ages of children.

Alexandria W did not have full CPR/First Aid training and was identified as a driver. Correction: All drivers must have current full CPR/First Aid training. Correct immediately and respond with statement of compliance by 8/17/23. Correct by 07/17/2023

Corrected Corrected by Jul 17, 2023

Category: transportation. Marked corrected in the state record.

7.701.32.E · . The request must be made within ten (10) calendar days of the first day of employment for each employee or facility on the State prescribed form, accompanied by the required fee paid by check or money order (for fee assessment see Section 7.000.73).

Reviewed 11 staff files and found Anali F's TRAILS background check was not submitted within 10 calendar days of hire. Correction: All individuals requiring a background check must review Navigating the Background Check Investigation Unit's (BIU) Webpage powerpoint. Submit verification that Anali has reviewed the powerpoint within 24 hours. Submit documentation of TRAILS Clearance Letters for staff members with written response to Specialist by 8/17/23. Correct by 07/17/2023

Corrected Corrected by Jul 17, 2023

Category: background checks. Marked corrected in the state record.