2.219.B.4 · 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 Recommendations for Preventive Pediatric Health Care schedule for routine well child exams.

Reviewed 6 child files. Observed 2 child files four years of age to have expired health statements. Correction: Facility must obtain current health statements and put in child files. Submit written verification on correction response to specialist. Correct by 06/08/2025

Corrected Corrected by Jun 8, 2025

Category: health medication. 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 3 staff files. Observed Gizelle to be missing documentation of department approved child abuse prevention training. Observed Arlene to have expired child abuse prevention training. Correction: Facility must obtain documentation of department approved child abuse prevention training and put in staff files. Submit written verification on correction response to specialist. Correct immediately. Correct by 05/08/2025

Corrected Corrected by May 8, 2025

Category: recordkeeping. Marked corrected in the state record.

2.217.C.9 · All Department-approved child care health consultants must complete the Department-approved training about child abuse prevention, which includes common symptoms and signs of child abuse or neglect. This training must be completed within thirty (30) days of hire and renewed every three (3) years.

Reviewed child care health consultant file. Observed Child Care Health Consultant to be missing documentation of department approved child abuse prevention training. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ Correction: Facility must obtain documentation of department approved child abuse prevention training for Child Care Health Consultant. Submit written verification on correction response to specialist. Correct by 06/08/2025

Corrected Corrected by Jun 8, 2025

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

2.220.F · Staff designated by the director to give medications must complete the Department-approved medication administration training and have current annual delegation or more often as determined by the Department-approved child care health consultant. Delegation must be from the center’s current Department-approved child care health consultant who must observe and document the competency of each staff member involved in medication FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ administration. All staff administering medication must have current cardiopulmonary resuscitation (CPR) and first aid training prior to administering medication with the following exceptions:

Reviewed 3 staff files. Observed Arlene assigned to administer medications to have expired delegation and expired department approved medication administration training. Correction: Facility must obtain documentation of current delegation and current department approved medication administration training for Arlene. Sumbit written verification on correction response to specialist. Correct immediately. Correct by 05/08/2025

Corrected Corrected by May 8, 2025

Category: ratio. Marked corrected in the state record.

2.213.H · 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 training course: Introduction to the Early Intervention and Preschool Special Education Programs. This course is required once and will be counted towards ongoing professional development.

Reviewed 3 staff files. Observed Gizelle to be missing documentation of department approved introduction to early intervention and preschool special education training. Correction: Facility must obtain documentation of department approved introduction to early intervention and preschool special education training. Submit written verification on correction response to specialist. Correct by 6/8/2025. Correct by 06/08/2025

Corrected Corrected by Jun 8, 2025

Category: recordkeeping. 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.

Reviewed 3 staff files. Observed Arlene to have expired department approved medication administration training and expired delegation. Correction: Facility must ensure there is at least one staff member with current department approved medication administration training and delegation on duty at all times. Submit written verification on correction response to specialist. Correct immediately. Correct by 05/08/2025

Corrected Corrected by May 8, 2025

Category: ratio. Marked corrected in the state record.

2.217.C.2 · the following topics: training, delegation and supervision of medication administration and special health procedures, health care plans, hygiene, disease prevention, equipment safety, nutrition, interaction between children and adult caregivers, and child growth and development.

Reviewed Child Care Health Consultant file. Observed Child Care Health Consultant to be missing FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ consultation for the month of April. Correction: Facility must obtain documentation of monthly consultation with Child Care Health Consultant. Submit written verification on correction response to specialist. Correct by 06/08/2025

Corrected Corrected by Jun 8, 2025

Category: supervision. Marked corrected in the state record.

2.217.C.6 · For the Department-approved child care health consultant, the center must maintain documentation of a brief biography highlighting applicable knowledge, experience, and approximate dates worked as a school nurse or child care health consultant.

Reviewed Child Care Health Consultant file. Observed Child Care Health Consultant to be missing documentation of brief biography. Correction: Facility must obtain documentation of a brief biography for current Child Care Health Consultant. Submit written verification on correction response to specialist. Correct by 06/08/2025

Corrected Corrected by Jun 8, 2025

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

2.217.C.8 · All Department-approved child care health consultants must complete the Department- approved Colorado Department of Public Health and Environment immunization course annually. The center must obtain and maintain proof of course completion.

Reviewed Child Care Health Consultant file. Observed Child Care Health Consultant to be missing documentation of department approved immunization training. Correction: Facility must obtain documentation of department approved immunization training for Child Care Health Consultant. Submit written verification on correction response to specialist. Correct by 06/08/2025

Corrected Corrected by Jun 8, 2025

Category: health medication. 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 3 staff files. Observed all staff to be missing documentation of emergency drill and fire extinguisher training. Correction: Facility must obtain documentation of training regarding fire safety and the use of available fire extinguishers and fire alarms and put in staff files. Submit written verification on correction response to specialist. Correct immediately. Correct by 05/08/2025

Corrected Corrected by May 8, 2025

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 3 staff files. Observed Gizelle to be missing documentation of department approved standard precautions training. Observed Kathryn to be missing signature on department approve standard precautions training. Correction: Facility must obtain documentation of department approved standard precautions training with signature. Submit written verification on correction response to specialist. Correct immediately. Correct by 05/08/2025

Corrected Corrected by May 8, 2025

Category: recordkeeping. Marked corrected in the state record.

2.120.C.1.a · The Trails child abuse or neglect records request must be made on the state-prescribed form, accompanied by the required fee within the following required time frames: Child care centers (less than 24-hour care), school-age child care facilities, family child care homes, and qualified exempt providers must meet the following: For all FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ individuals whose activities involve the care or supervision of children or who have unsupervised access to children, requests must be submitted and successfully completed prior to caring for children or allowing unsupervised access to children.

Reviewed 3 staff files. Observed Arlene to be missing documentation of TRAILS clearance. Correction: All individuals requiring a background check must review Navigating the Background Check Investigation Unit's (BIU) Webpage powerpoint. Submit verification that staff member Arlene have reviewed the powerpoint within 24 hours. Submit documentation of TRAILS for staff member Arlene with written response to the Specialist. Correct immediately. Correct by 05/08/2025

Corrected Corrected by May 8, 2025

Category: supervision. Marked corrected in the state record.

2.121.D.4.a · Criminal background check requests must be successfully completed 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.

Reviewed 3 staff files. Observed Arlene to be missing documentation of FBI and CBI clearance. Correction: All individuals requiring a background check must review Navigating the Background Check Investigation Unit's (BIU) Webpage powerpoint. Submit verification that staff member Arlene have reviewed the powerpoint within 24 hours. Submit documentation of FBI and CBI for staff member Arlene with written response to the Specialist. Correct immediately. Correct by 05/08/2025

Corrected Corrected by May 8, 2025

Category: supervision. Marked corrected in the state record.

2.126.A · A child care facility must require each staff member of the facility to read and sign a statement clearly defining child abuse and neglect pursuant to state law and outlining the staff member’s personal responsibility to report all incidents of child abuse or neglect according to state law.

Reviewed 3 staff files. Observed Gizelle to be missing documentation of abuse form. Correction: Facility must obtain documentation of child abuse statement pursuant to state law. Submit written verification on correction response to specialist. Correct immediately. Correct by 05/08/2025

Corrected Corrected by May 8, 2025

Marked corrected in the state record.

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 3 staff files. Observed Arlene and Gizelle to be missing documentation of department approved FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ training in emergency and disaster preparedness. Correction: Facility must obtain documentation of department approved training in emergency and disaster preparedness and put in staff files. Submit written verification on correction response to specialist. Correct immediately. Correct by 05/08/2025

Corrected Corrected by May 8, 2025

Category: recordkeeping. 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 6 child files. Observed 3 to have expired emergency medical authorization. Correction: Facility must obtain current documentation of written authorization for emergency medical care and put in child files. Submit written verification on correction response to specialist. Correct immediately. Correct by 05/08/2025

Corrected Corrected by May 8, 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 children. This training must be renewed annually and will be counted towards ongoing professional development.

Staff member Arlene S. did not have verification of an updated Standard Precautions training. Correction: All staff must complete a Department approved Standard Precautions training prior to working with children. This training must be renewed annually. Correct immediately. Submit documentation and a written statement of compliance by 10/21/24. Correct by 09/23/2024

Corrected Corrected by Sep 23, 2024

Category: recordkeeping. Marked corrected in the state record.

2.214.A · Large center directors must have a current director qualifications letter issued by the Department or a current early childhood professional credential level III or higher in version 3.0 as determined by the Department prior to working as the director of a large center.

Staff member Arlene S. did not have verification of an updated Large Center Directors letter. Correction: The center director must submit and obtain an update qualifications letter issued by the Department prior to working as a director of a large center. The director must renew the their directors prior to it expiring. Correct immediately. Submit documentation and a written statement of compliance by 10/21/24. Correct by 09/23/2024

Corrected Corrected by Sep 23, 2024

Marked corrected in the state record.

2.217.C.1.a · Center staff must have a monthly consultation with a current Department-approved Child Care Health Consultant who must meet one (1) of the following qualifications: A Licensed Registered Nurse with knowledge and experience in maternal and child health.

Identified through the statement of the Director and office administrator, the center's health consultant is no longer acting as the preschool Child Care Health Consultant and they have not yet found a replacement. Correction: The Center must have a monthly department approved Child Care Health Consultant that meets with the staff. Correct immediately. Submit documentation and a written statement of compliance by 10/21/24. Correct by 09/23/2024

Corrected Corrected by Sep 23, 2024

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

2.217.C.7 · All Department-approved child care health consultants must complete the Department-approved child care health consultant introductory training course within six (6) months of hire. Child care health consultants must complete Department-approved ongoing professional development training every three (3) years. The center must obtain and maintain proof of training completion.

Identified through the statement of the Director and office administrator, the center's health consultant is no longer acting as the preschool Child Care Health Consultant and they have not yet found a replacement. Correction: All Department approved child care health consultant must complete the approved child care health consultant introductory training and update every three years. Submit documentation and a written statement of compliance by 10/21/24. Correct by 10/21/2024

Corrected Corrected by Oct 21, 2024

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

2.217.C.8 · All Department-approved child care health consultants must complete the Department- approved Colorado Department of Public Health and Environment immunization course annually. The center must obtain and maintain proof of course completion.

Identified through the statement of the Director and Office Administrator, the center's health consultant is no longer acting as the preschool Child Care Health Consultant and they have not yet found a replacement. Correction: All department approved child care health consultant must complete the approved Colorado Department pf Public Health and Enviroment immunization course annually. Submit documentation and a written statement of

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

2.217.C.9 · All Department-approved child care health consultants must complete the Department-approved training about child abuse prevention, which includes common symptoms and signs of child abuse or neglect. This training must be completed within thirty (30) days of hire and renewed every three (3) years.

Identified through the statement of the Director and Office Administrator, the center's health consultant is no longer acting as the preschool Child Care Health Consultant and they have not yet found a replacement. Correction: All department approved child care health consultant must complete the approved child abuse and neglect training. This training must be updated every 3 years. Submit documentation and a written statement of compliance by 10/21/24. Correct by 10/21/2024

Corrected Corrected by Oct 21, 2024

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