2.312.Q · Within ninety (90) calendar days of caring for children the primary provider, applicant 2, and the equally qualified provider must complete the Department-approved training “Working with an Early Childhood Mental Health Consultant.” This course is required once and will be counted toward ongoing professional development.

Reviewed provider's file and observed Traci to be missing documentation of the training Working with an Early Childhood Mental Health Consultant. Correction: Obtain documentation of the Department approved training "Working with an early Childhood Mental Health Consultant" and add to file Send documentation of compliance to specialist with response form Correct by 06/12/2025

Corrected Corrected by Jun 12, 2025

Category: health medication. 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 FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ guardian(s). The authorization must be notarized if required by the local hospital, clinic, or emergency health care facility;

Reviewed 16 children's files and observed 3 files to be missing documentation of current written authorization fr emergency medical care. Correction: Obtain documentation of current written authorization for emergency medical care, signed and dated by the parent of guardian and add to files. Correct immediately. Submit a written statement of compliance to specialist with response form Correct by 05/13/2025

Corrected Corrected by May 13, 2025

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

2.321.A.2.c · At the time of admission, the parent or guardian must provide the following information to the provider for each child entering the family child care home: Documentation of school-required immunization status or 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 (CDPHE) certificate of immunization or on an "approved alternate" certificate of immunization as described in CDPHE regulations at 6 CCR 1009-2:VI(A), (May 15, 2023), no later editions or amendments are incorporated. These regulations are available from the Colorado Department of Public Health and Environment at no cost at www.sos.state.co.us/CCR. These regulations are also available for public inspection and copying at the Colorado Department of Early Childhood, 710 S. Ash St., Denver, CO 80246, during regular business hours.. Colorado law requires that proof of immunization be provided prior to the first day of admission.

Reviewed 16 children's records and observed 3 files to be missing documentation of immunization records. Observed 2 files to have immunization records on unapproved forms. Correction: Obtain documentation of immunization records and add to files. Correct immediately Transfer immunization record to a Colorado Department of Public Health and Environment approved form. Correct immediately Submit a written statement of compliance to specialist with response form Correct by 05/13/2025

Corrected Corrected by May 13, 2025

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

2.321.A.5 · Health statements for children over two (2) years to seven (7) years of age must be updated in FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ accordance with the American Academy of Pediatrics Recommendations for Preventive Pediatric HealthCare or as required in writing by health care provider.

Reviewed 16 children's files and observed 2 files to be missing documentation of health statements( children over 2 years to 7 years of age). Correction: Obtain documentation of health statements and add to files. Submit a written statement of compliance to specialist with response form Correct by 06/12/2025

Corrected Corrected by Jun 12, 2025

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

2.321.A.6 · For children seven (7) years of age and older, health statements must be updated every three (3) years as long as the children are in care.

Reviewed 16 children's files and observed 2 files to be missing documentation of current health statements (children 7 years of age and older). Correction: Obtain documentation of current health statements and add to files Submit a written statement of compliance to specialist with response form Correct by 06/12/2025

Corrected Corrected by Jun 12, 2025

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

2.335.N · Any animals in the family child care home must be vaccinated as required by state law and local ordinance, and proof of vaccination must be available for review by the licensing specialist.

Reviewed provider's file and observed Traci to be missing documentation of current vaccination records for the family dog. Correction: Obtain documentation of current vaccination records for the family dog and add to file. Correct immediately. Submit a written statement of compliance to specialist with response form Correct by 05/13/2025

Corrected Corrected by May 13, 2025

Category: recordkeeping. Marked corrected in the state record.

2.335.D · The premises of the family child care home must be kept safe and free from hazards to health at all times.

A re-fill bottle of hand soap labeled "keep out of reach of children" in an unlocked cabinet in the sleep room bathroom, accessible to children. Correction: The premises of the home must be kept safe and free from hazards to health at all times. Correct immediately. Submit a written statement of compliance to specialist with response form Correct by 05/13/2025

Corrected Corrected by May 13, 2025

Category: health medication. 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.

Several small magnet used to display items on a white board in the entry of the home where children enter, posing a potential choke hazard. Correction: Toys, toy parts, furnishings, equipment and any materials accessible to children under 3 years of age must not be a choke hazard. Correct immediately. Corrected at the time of inspection. Provider removed the magnets, making them inaccessible to children 6/19/2024. No response required for this violation. Correct by 06/19/2024

Corrected Corrected by Jun 19, 2024

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

2.335.K · Drinking water obtained from a source other than a regulated public water system must be tested annually for total coliform, e. Coli bacteria, and nitrate, at a minimum. The results must be in compliance with rule section 11.45 of the “Colorado Primary Drinking Water Regulations” located in 5 CCR 1002-11. Results must be maintained and available for review. The Colorado Primary Drinking Water Regulations (January 14, 2023), are herein incorporated by reference. No later FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ editions or amendments are incorporated. These rules are available at no cost from the Colorado Department of Public Health And Environment, 4300 Cherry Creek Drive South Denver, CO 80246; or at www.sos.state.co.us. These rules are also available for inspection and copying at the Department, 710 S. Ash Street, Bldg. C, Denver, Colorado 80246, during regular business hours.

Reviewed provider's file and observed Traci to be missing documentation of a current annual water test. Correction: Obtain documentation of a current water test and add to file. Correct immediately. Submit a written statement of compliance to specialist with response form. Correct by 06/19/2024

Corrected Corrected by Jun 19, 2024

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

2.335.D · The premises of the family child care home must be kept safe and free from hazards to health at all times.

Observed 3 tubs of disinfectant wipes labeled "keep out of reach of children" in an unlocked drawer in the back bathroom, accessible to children. Observed a pouch of baby wipes labeled "keep out of reach of children" in an unlocked drawer in the middle bathroom, accessible to children. Observed a large, loose plastic bag in an unlocked drawer in the back bathroom, accessible to children, posing a potential hazard. Observed a thumb tack in the wall above the office door posing a potential hazard. Correction: The premises of the family child care must be kept safe and free from hazards at all times. Correct immediately. Corrected at the time of inspection. Provider moved all items labeled "keep out of reach of children" to high cabinets, inaccessible to children, removed the thumb tack, and moved the plastic bag to an area inaccessible to children 6/19/2024. Correct by 06/19/2024

Corrected Corrected by Jun 19, 2024

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

2.321.A.5 · Health statements for children over two (2) years to seven (7) years of age must be updated in accordance with the American Academy of Pediatrics Recommendations for Preventive Pediatric HealthCare or as required in writing by health care provider.

Reviewed 13 children's files and observed 4 files to be missing documentation of current health statements. Correction: Obtain documentation of current health statements and add to files.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

2.321.A.3 · Within thirty (30) days after admission, and within thirty (30) days following the expiration date, the 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 13 children's files and observed 2 files to be missing documentation of health statements. Correction: Obtain documentation of health statements and add to files. Submit written statement of compliance to specialist with response form Correct by 07/18/2024

Corrected Corrected by Jul 18, 2024

Category: ratio. Marked corrected in the state record.

2.321.A.2.c · At the time of admission, the parent or guardian must provide the following information to the provider for each child entering the family child care home: Documentation of school-required immunization status or 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 (CDPHE) certificate of immunization or on an "approved alternate" certificate of immunization as described in CDPHE regulations at 6 CCR 1009-2:VI(A), (May 15, 2023), no later editions or amendments are incorporated. These regulations are available from the Colorado Department of Public Health and Environment at no cost at www.sos.state.co.us/CCR. These regulations are also available for public inspection and copying at the Colorado Department of Early Childhood, 710 S. Ash St., Denver, CO 80246, during regular business hours.. Colorado law requires that proof of immunization be provided prior to the first day of admission.

Reviewed 13 children's files and observed 2 files to be missing documentation of immunization records. Observed 3 files to have immunization records on an unapproved form. Correction: Obtain documentation of immunization records and add to file. Correct immediately.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

2.320.A.9 · 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 field trips and excursions can occur on a daily, weekly, monthly, or seasonal basis.

Reviewed 13 children's files and observed 2 files to be missing documentation of signed authorization for field trips and excursions. Correction: Obtain written authorization for field trips and excursions and add to file. Correct immediately ( or prior to any field trips or excursions). Submit a written statement of compliance to specialist with response form. Correct by 06/19/2024

Corrected Corrected by Jun 19, 2024

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 13 children's files and observed 2 files to be missing documentation of written authorization for emergency medical care signed by parents/ guardians. Observed 2 files to be missing documentation of current written authorization for emergency medical care. Correction: Obtain current written authorization for emergency medical care signed and dated by parents/ guardians and add to files. Correct immediately. Correct by 06/19/2024

Corrected Corrected by Jun 19, 2024

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

2.320.A.5 · An admission record must be completed for each child prior to or at the time of the child’s admission FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ and updated annually or when any changes occur, unless otherwise specified in these rules. The admission record must include: Names, addresses, and telephone numbers of the child’s health care provider, dentist, and hospital of choice, if applicable;

Reviewed the admission form and observed it to be missing hospital of choice address. Correction: Add hospital of choice address and make available to parents to fill out . Correct immediately. Submit a written statement of compliance to specialist with response form. Correct by 06/19/2024

Corrected Corrected by Jun 19, 2024

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

2.320.A.3 · 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: Names, addresses, and telephone numbers of persons aged sixteen (16) years and older who are authorized to pick up the child from the family child care home;

Reviewed the admission form and observed it to be missing addresses of persons aged 16 and older who are authorized to pick up the child from the family child care home. Correction: Add addresses of authorized persons to pick the child up from the family child care home and make available to parents to fill out. Submit a written statement of compliance to specialist with response form Correct by 06/19/2024

Corrected Corrected by Jun 19, 2024

Category: recordkeeping. 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 needs to be on file if media use is not addressed in the home policies and procedures statement; and

Reviewed 13 children's files and observed 1 file to be missing documentation written authorization media use. Correction: Obtain documentation of written authorization for media use and add to file. Correct immediately.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

2.121.D.5 · Every five (5) years, requests for FBI criminal record checks must be renewed by completing the fingerprint process at an approved vendor. An updated clearance letter or verification of the submission of the request must be obtained prior to five (5) years from the date reflected on the current clearance letter.

Reviewed providers records and observed Traci and Juston to be missing current FBI cleaeance letters. Correction: Every five years, requests for FBI criminal record checks must be renewed. Provider must review Navigating the Background Check Investigation Unit's (BIU) Webpage powerpoint. Submit verification the provider reviewed the powerpoint within 24 hours. Notify Licensing Specialist in writing once the resident has completed the fingerprinting process. Correct by 06/19/2024

Corrected Corrected by Jun 19, 2024

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

2.316.B.17 · The written policies and procedures must be developed, implemented, and followed, by the primary provider, applicant 2, equally qualified providers, qualified substitutes, and all staff members including all amendments, and must include at a minimum the following information:Policy on transitioning a child from breast feeding to a bottle and/or cup, or from a bottle to a cup;

Reviewed the written policy and procedure statement and observed it to be missing a policy on the procedure on transitioning a child from breast feeding to a bottle and/ or a bottle to a cup. Correction: Add the missing policy to the written policy and procedure statement and make available to parents. Submit a written statement of compliance to specialist with response form Correct by 07/18/2024

Corrected Corrected by Jul 18, 2024

Marked corrected in the state record.

7.707.31.A.10 · Subsequent health evaluations for the provider and children residing in the home who are less than twelve (12) years of age must be submitted every two (2) years or as required in a written plan signed by a physician or other health professional. A new family member and/or a new resident of the home must submit to the State Department, within thirty (30) days from the date the individual began living in the home, a State Department approved health evaluation form signed and dated by a licensed physician or other health professional.

Reviewed provider's health evaluation on file and found the most current expired January 2023. Correction: Obtain a current health evaluation and submit a copy to the licensing specialist. Correct and notify licensing specialist in writing. Correct by 08/13/2023

Corrected Corrected by Aug 13, 2023

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