2.311.A.14.a · All equally qualified providers, qualified substitutes, and all staff members must obtain a subsequent health evaluation every two (2) years or as required in a written plan signed by a licensed physician or other health care provider.

Reviewed 2 staff files and observed expired health statements (11/27/223) Correction: Obtain and maintain current and up to date health statements for all staff. Correct and submit written compliance by 4/19/2025. Correct by 04/19/2025

Corrected Corrected by Apr 19, 2025

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

2.320.A.10 · An admission record must be completed for each child prior to or at the time of the child’s admission and updated annually or when any changes occur, unless otherwise specified in these rules. The admission record must include: Written authorization for media use is required if the media use is not included in the written policies and procedures statement; including, but not limited to, television and video viewing, music, tablet and/or smart phone usage, video games, and computer use. The authorization must include approved time limits. The authorization form only FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ needs to be on file if media use is not addressed in the home policies and procedures statement; and

Reviewed 17 children files and observed all 17 children did not have written authorization for media use. Correction: Obtain and maintain written authorization for media use for all children enrolled. Correct immediately 3/19/2025 and submit written compliance by 4/19/2025. Correct by 03/19/2025

Corrected Corrected by Mar 19, 2025

Category: recordkeeping. Marked corrected in the state record.

2.320.A.7 · An admission record must be completed for each child prior to or at the time of the child’s admission and updated annually or when any changes occur, unless otherwise specified in these rules. The admission record must include: A dated, written authorization for emergency medical care signed and updated annually by the parent(s) or guardian(s). The authorization must be notarized if required by the local hospital, clinic, or emergency health care facility;

Reviewed 17 children files and observed all 17 children with emergency medical authorization to be missing the date parent signed and authorized permission. Correction: Obtain and maintain current and up to date signed and date emergency medical authorization for all children enrolled. Correct immediately 3/19/2025 and submit written compliance by 4/19/2025. Correct by 03/19/2025

Corrected Corrected by Mar 19, 2025

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

2.321.A.2.c.1 · If the parent(s) or guardian(s) of a child wants a nonmedical exemption from the immunization requirement based on a religious belief whose teachings are opposed to immunizations or a personal belief that is opposed to immunizations, the child's parent(s) or guardian(s) must submit the CDPHE Certificate of Nonmedical Exemption (May 2023) with a signature from an immunizing provider in Colorado, or

Reviewed 17 children files and observed 1 child to have an immunization exemption form without a signature from an immunizing provider in Colorado Correction: Obtain and maintain current and up to date immunization records on a Colorado approved form and signed by an immunizing provider in Colorado. Correct immediately 3/19/2025 and submit written compliance by 4/19/2025 Correct by 03/19/2025

Corrected Corrected by Mar 19, 2025

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

2.321.A.3 · Within thirty (30) days after admission, and within thirty (30) days following the expiration date, the FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ parent(s) or 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 under two and one-half (2-1/2 ) 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 licensed family child care home.

Reviewed 17 children files and observed 3 children to have expired health statements. Correction: Obtain and maintain current and up to date health statements for all children enrolled. Correct and submit written compliance by 4/19/2025 Correct by 04/19/2025

Corrected Corrected by Apr 19, 2025

Category: ratio. Marked corrected in the state record.

2.336.B.1 · Toys, toy parts, furnishings, equipment, and any materials accessible to children under three (3) years of age must not be a choke hazard or able to be inhaled.

During safety walk through, observed balls labeled 3+ and small plastic toy screws that fit into a choke tube, to be accessible to children in the playroom. Correction: Ensure all items accessible to children under 3yrs are not a choke hazard or can be inhaled. Correct immediately 3/19/2025. ***Corrected at time of visit by removing toys. No response required. Correct by 03/19/2025

Corrected Corrected by Mar 19, 2025

Category: physical safety. 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 reach of children.”

During safety walk through, observed items "keep out of reach of children" accessible to children (in the bathroom drawers that had mouth wash and makeup, to not be latching, laundry room door was open and a bottle of detergent on the floor) Correction: Ensure all items labeled "keep out of reach of children" are inaccessible to children at all times. Correct immediately 3/19/2025. ***Corrected at time of visit by making items inaccessible to children. No response required. Correct by 03/19/2025

Corrected Corrected by Mar 19, 2025

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