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 24 children's records and observed seven records to be missing documentation of updated and current emergency medical authorizations. Correction: Obtain current emergency medical authorization for all children's records. Correct immediately by 10.9.2025, and submit a written statement of compliance to the Specialist by 11.9.2025. Correct by 10/09/2025

Corrected Corrected by Oct 9, 2025

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 FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ submitted annually.

Reviewed 18 staff records and observed staff member 14 to be missing documentation of the required medical statement. Correction: Obtain documentation of the required medical statements for all staff members as required. Correct by 11.9.2025, and submit a written statement of compliance to the Specialist. Correct by 11/09/2025

Corrected Corrected by Nov 9, 2025

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

2.213.C · Staff working with infants less than twelve (12) months old must complete a Department-approved 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 18 staff records and observed staff member four to be missing documentation of the required Department- approved safe sleep training. Observed the staff member to work with children under the age of 12 months. Correction: Obtain documentation of the required Department-approved safe sleep training for all staff members who work with children under the age of 12 months as required. Correct immediately by 10.9.2025, and submit a written statement of compliance to the Specialist by 11.9.2025. Correct by 10/09/2025

Corrected Corrected by Oct 9, 2025

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 18 staff records and observed staff member four to be missing documentation of the required Department- approved prevention of shaken baby/abusive head trauma training. Observed the staff member to work with children under the age of three years. Correction: Obtain documentation of the required Department- approved prevention of shaken baby/abusive head trauma training for all staff members who work with children under the age of three years as required. Correct immediately by 10.9.2025, and submit a written statement of compliance to the Specialist by 11.9.2025. Correct by 10/09/2025

Corrected Corrected by Oct 9, 2025

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 18 staff records and observed staff member to eight be missing documentation of the required Department approved training about child abuse and prevention. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ Correction: Obtain documentation of the required Department- approved abuse prevention training for all staff members as required. Correct immediately by 10.9.2025, and submit a written statement of compliance to the Specialist by 11.9.2025. Correct by 10/09/2025

Corrected Corrected by Oct 9, 2025

Category: recordkeeping. Marked corrected in the state record.

2.218.C.5.a · 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: Medication and dosing schedule;

Observed one child's health care plan to be missing documentation of the required parental/ guardian signature, and one health care plan to be expired. Correction: Obtain documentation of the required updated health care plan and parental/ guardian signatures as required. Correct immediately by 10.9.2025, and submit a written statement of compliance to the Specialist by 11.9.2025. Correct by 10/09/2025

Corrected Corrected by Oct 9, 2025

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

2.219.B.2 · 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 FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ statement must include when the next visit is required by the health care provider. All health statements must be kept at the center.

Reviewed 24 children's records and observed one child's record to be missing documentation of the required health statement. Correction: Obtain the required health statements for all children's records. Correct immediately by 11.9.2025, and submit a written statement of compliance to the Specialist. Correct by 11/09/2025

Corrected Corrected by Nov 9, 2025

Category: ratio. 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.

Documentation shows that fire and tornado drills were not conducted in July or August, posing a potential safety hazard. Correction: Emergency drills must be completed as required. Correct immediately by 9.5.2025, and submit a written statement of compliance to the Specialist y 9.12.2025. Correct by 09/05/2025

Corrected Corrected by Sep 5, 2025

Category: recordkeeping. Marked corrected in the state record.

2.124.A.1.b · Within twenty-four (24) hours, excluding weekends and holidays, of the occurrence of a critical incident at the facility or within twenty-four (24) hours of a child’s return to the facility the licensee must report in writing to the Colorado Department of Early Childhood, Division of Early Learning, Licensing, and Administration the following critical incidents involving a child in the care of the facility or a staff member on duty: An injury to a child that requires medical attention by a health care professional or admission to a hospital, whether or not treatment was given. This report must be completed in the online injury system within 24 hours of an incident. If a provider is unable to access the online system, you must use the paper form, and submit the form to the Department within 24 hours of the incident.

Identified through staff statements that there was a child who had an injury to the nose and the facility called 911 to seek medical attention. The facility failed to report the injury to licensing as required. Correction: Within 24 hours of an injury to a child that requires medical attention must be reported to the Department. Correct immediately by 9.5.2025, and submit a written statement of compliance to the Specialist by 9.12.2025. Correct by 09/05/2025

Corrected Corrected by Sep 5, 2025

Category: ratio. Marked corrected in the state record.

2.124.A.1.k · Within twenty-four (24) hours, excluding weekends and holidays, of the occurrence of a critical incident at the facility or within twenty-four (24) hours of a child’s return to the facility the licensee must report in writing to the Colorado Department of Early Childhood, Division of Early Learning, Licensing, and Administration the following critical FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ incidents involving a child in the care of the facility or a staff member on duty: Any police or sheriff contact with the facility.

Identified through staff statements that the facility called 911 multiple times, including for someone irate, an injury to a child, and a family member, and a potential gas leak. Correction: Within 24 hours of a reportable incident the facility must report the incident to the Department. Correct immediately by 9.5.2025, and submit a written statement of compliance to the Specialist by 9.12.2025. Correct by 09/05/2025

Corrected Corrected by Sep 5, 2025

Category: ratio. Marked corrected in the state record.

2.129.A.3 · Each licensed child care facility shall maintain records as required by the Department pertaining to the admission, progress, health, and discharge of children in care at the facility. All information regarding children and their families shall be kept confidential.

Identified through staff statements that each classrooms photos were uploaded into a cloud. All families for that classroom were provided with a code and all families from that classroom were able to see photos for all children in the classroom. Correction: Information regarding children and their families must remain confidential. Correct immediately by 9.5.2025, and submit a written statement of compliance to the Specialist. Correct by 09/05/2025

Corrected Corrected by Sep 5, 2025

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

2.134.A · All child care providers must have a written plan for: evacuating and safely moving children to an alternate site; lockdown; shelter in place; and an active shooter on premises. The plan must include provisions for multiple types of hazards, such as floods, fires, tornadoes, and active shooter situations. The plan must be updated as changes occur and reviewed annually. All employees of a child care provider must also be annually trained on the provider’s written plan prior to caring for children, and retrained as changes occur. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________

The facility to have a written evacuation plan to include an alternative location that is not in operation during the all of the childcare hours. Identified that the facility needed to evacuate and the alternative location was closed. Identified that the children were evacuated into the buses which is not documented in the evacuation plan. Identified through staff statements that there was an irate individual outside, and the facility needed to call 911 due to safety concerns. Identified that the facility did not follow their policy and call for shelter in place. Correction: All child care providers must have a written plan for evacuation and the plan must be implemented. Correct immediately by 9.5.2025, and submit a written statement of compliance to the Specialist by 9.12.2025. Correct by 09/05/2025

Corrected Corrected by Sep 5, 2025

Category: ratio. 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.

In the Vience toddler classroom observed 9 children and one staff member unpon the Specialist's arrival, posing a potential safety hazard. Correction: The staff to child ratio must be maintained at all times. Corrected at the time of the inspection. An addtional staff member when into the classroom. Correct by 09/05/2025

Corrected Corrected by Sep 5, 2025

Category: ratio. Marked corrected in the state record.

2.223.D.5.a.1 · Cots or pads must be spaced at least two (2) feet apart on all sides during rest time. Children must have a safe area in which to rest that is easily supervised, out of the path of traffic, and free of hazards.

Cots in the Barcelona classroom to be one foot apart, and cots in the Milan classroom to be touching, posing a potential health hazard. Correction: Cots must be at least two feet apart. Corrected at the time of the inspection. The cots were moved and placed at least two feet a part. No response required. Correct by 09/05/2025

Corrected Corrected by Sep 5, 2025

Category: supervision. Marked corrected in the state record.

2.229.K · Evacuation equipment must not block exit routes. Nothing may be stored in or under any evacuation equipment. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________

A tote with supplies under the evacuation crib in the Rome infant classroom, posing a potential safety hazard. Correction: Nothing may be stored in and or under evacuation cribs. Corrected at the time of the inspection. The tote was removed from under the crib. No response required. Correct by 09/05/2025

Corrected Corrected by Sep 5, 2025

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

2.206.B.9.a · The written policies and procedures must be developed, implemented, and followed, and must include at a minimum the following information: How decisions are made and what steps are taken prior to the suspension, expulsion, or request to parents or guardians to withdraw a child from care due to concerns about the child’s behavioral issues. These procedures must be consistent with the center’s policy on guidance and positive instruction, and include documentation of the steps taken to understand and respond to challenging behavior including: Identify and consult with an early childhood mental health consultant, AS DEFINED IN SECTION 26.5-3-701, C.R.S or other specialist as needed.

The facility was missing policies and procedures that address what steps are taken prior to suspension or expulsion including identifying a specialist as needed. Correction: Obtain a policy and procedure that addresses what steps are taken prior to suspension or expulsion including

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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 one staff record and observed Sarah N. (DOH 2.27.2024) to be missing the required and current abuse prevention training. Correction: Obtain the required abuse prevention training for all staff as required. Correct immediately by 4.25.2025, and submit a written statement of compliance to the Specialist by 5.2.2025. Correct by 04/25/2025

Corrected Corrected by Apr 25, 2025

Category: recordkeeping. 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.

The Toddler classroom (Dublin) to be in the stage multipurpose space upon the Specialist's arrival. Observed there to be one teacher and six children, posing a potential safety hazard. Correction: Staff to child ratio must be maintained at all times. Correct immediately by 4.25.2025, and submit a written

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

2.229.K · Evacuation equipment must not block exit routes. Nothing may be stored in or under any evacuation equipment.

Evacuation cribs in both the Rome and Paris infant classrooms are being used for storage, including equipment and boppies, presenting a potential safety hazard. Correction: Nothing may be stored inside of the evacuation cribs. Corrected at the time of the inspection. The teachers removed the items stored in the cribs. No response required. Correct by 04/25/2025

Corrected Corrected by Apr 25, 2025

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

2.233.C.2 · If the toddler program is combined with a large child care center or an infant program, toddler facilities, both indoor and outdoor, must be completely separate from facilities for other age groups, except as allowed by rule sections 2.232(A)(6) and (8). If the facility wishes to provide opportunities for a toddler to have occasional contact with siblings, plans must be approved by the Department licensing representative.

Identified through staff statements that a preschool age child was brought to the toddler playground with toddlers playing outside on 4.7.2025. Correction: Toddlers and preschool age children must remain separate. Correct immediately by 4.25.2025, and submit a written statement of compliance to the Specialist by 5.2.2025. Correct by 04/25/2025

Corrected Corrected by Apr 25, 2025

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

2.230.B · Indoor and outdoor equipment, materials, and furnishings must be sturdy, safe, and free of hazards.

Two electrical plugs, for a tablet or cell phone, to be exposed in the pre-k classroom, near the circle time rug, posing a potential safety hazard. Correction: Indoor equipment, materials, and furnishings must be free from hazards. Corrected at the time of the inspection. The Director removed the electrical plug from within reach of children. No response required. Correct by 11/20/2024

Corrected Corrected by Nov 20, 2024

Category: physical safety. 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 25 staff records and observed two staff members Natalie M. (DOH 8.15.2024) and Mackinzie F. (DOH 8.28.2024) to be missing documentation of a current health statement. Correction: Obtain required health statements for all staff members as required. Correct by 12.20.2024 and submit a

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

2.220.C · Medications must be kept in the original labeled bottle or container. Prescription medications must contain the original pharmacy label.

Medication in the Pre-K classroom to be missing a prescription label. Correction: Obtain the original prescription label for all staff members. Correct immediately by 11.20.2024, and submit a written statement of compliance to the Specialist by 12.20.2024. Correct by 11/20/2024

Corrected Corrected by Nov 20, 2024

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

2.229.L · Toys, toy parts, furnishings, equipment, and any materials accessible to children under than three (3) years of age must not be a choke hazard or able to be inhaled. Any area of the facility accessible to children less than three (3) years of age must be free of any choke or inhalation hazards.

Small ornaments on a Christmas trees in the 112 (Madeira) classroom accessible to children under the age of three. Correction: Toys, toy parts, furnishings, equipment and any materials accessible to children under the age of three must not pose a choke hazard. Correct immediately by 11.20.2024, and submit a written statement of compliance to the Specialist by 12,20,2024. Correct by 11/20/2024

Corrected Corrected by Nov 20, 2024

Category: physical safety. 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.

A health care plan in the 112 (Madeira) classroom to be missing documentation of written parental consent. Correction: Obtain written consent from families to administer medications. Correct immediately by 11.20.204, and submit a written statement of compliance to the Specialist by 12.20.2024. Correct by 11/20/2024

Corrected Corrected by Nov 20, 2024

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.

Reviewed 25 staff records and observed five staff members Cathyann S., Kelsie T., Juliana R., Sarah N., and Naike S.,to have expired standard precautions training. Correction: Obtain standard precautions training for all staff as required. Correct immediately by 11.20.2024, and submit a written statement of compliance to the Specialist 12.20.2024. Correct by 11/20/2024

Corrected Corrected by Nov 20, 2024

Category: recordkeeping. Marked corrected in the state record.

2.219.B.3 · Statements of health status of children less than two (2) years of age must be updated as required in writing by the health care provider, or in accordance with the American Academy of Pediatrics Recommendations for Preventive Pediatric Health Care schedule at https://downloads.aap.org/AAP/PDF/periodicity_schedule.pdf, (4th ed. American Academy of Pediatrics; (2017) herein incorporated by reference. No later editions or amendments are incorporated. These recommendations are available at no cost from https://www.aap.org/. These recommendations are also available for public inspection and copying at the Colorado Department of Early Childhood, 710 S. Ash St., Bldg. C, Denver, CO 80246, during regular business hours.

Reviewed 16 children's records and observed two children to be missing documentation of the required up to date health statements. Correction: Obtain current health statements for all children as required. Correct by 12.20.2024, and submit a written statement of compliance to the Specialist. Correct by 12/20/2024

Corrected Corrected by Dec 20, 2024

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

2.120.C.1.a.1 · 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: Individuals who have obtained a successfully completed CBI or FBI record check may care for children, for no longer than FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ ninety (90) calendar days, while waiting for all other required background checks to be completed. The individual must be supervised at all times by an individual who has successfully completed all required background checks.

Reviewed 25 staff records and observed one staff member (Monica M., DOH 7.26.2024) to be missing documentation of the required Trails background check. Correction: Obtain documentation of the required Trails background check for all staff members as required. Correct immediately by 11.20.204, and submit a written statement of compliance and documentation of the background to the Specialist by 12.20.2024. Submit verification that staff members Monica M. has reviewed the powerpoint within 24 hours. Correct by 11/20/2024

Corrected Corrected by Nov 20, 2024

Category: supervision. 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 25 staff records and observed seven staff members Cathyann S., Raquel M., Juliana R., Destyni R., Katie T., Emily G., Charolette A. to be missing documentation of the required use of available fire extinguishers. Correction: Each staff member must be training in the use of available fire extinguishers. Correct immediately by 11.20.2024, and submit a written statement of compliance to the Specialist by 12.20.2024. Correct by 11/20/2024

Corrected Corrected by Nov 20, 2024

Category: recordkeeping. 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 25 staff records and observed two staff members Aahlina V., DOH (9.23.2024) and Sydnie B. (DOH 5.13.2024) to be have expired CPR and First Aid modules. Correction: Obtain the required CPR and First Aid module for all staff as required. Correct by 11.20.2024, and submit a written statement of compliance to the Specialist by 12.20.2024. Correct by 11/20/2024

Corrected Corrected by Nov 20, 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.

Identified that staff member Juliana R. (DOH 1.1.2024) collects and reviews immunization records and observed the training module to be missing. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ Correction: Obtain the required immunization module for all staff who maintain, collect, and review children's immunization records. Correct by 12.20.2024, and submit a written statement of compliance to the Specialist. Correct by 12/20/2024

Corrected Corrected by Dec 20, 2024

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

2.121.J.1 · 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:

Reviewed 25 staff records and observed one staff member Lisa W. (DOH 9.13.2024) to have lived outside of the state of Colorado within the last five years to be missing documentation of the required out of state background check. Correction: Obtain out of state background checks for all employees who have lived out side of the state of Colorado within the last five years. Correct immediately by 11.20.2024, and submit a written statement of compliance and documentation of the background to the Specialist by 12.20.2024. Submit verification that staff members Lisa W. have reviewed the powerpoint within 24 hours. Correct by 11/20/2024

Corrected Corrected by Nov 20, 2024

Category: supervision. Marked corrected in the state record.

Violation

Reviewed 6 staff files and observed Jullian H., missing CBI and FBI, Destyni R. missing FBI, and Jennifer L, missing FBI, clearance letters. Correction: All individuals requiring a background check must review Navigating the Background Check Investigation Unit's (BIU) Webpage powerpoint. Submit verification that staff members Jullian H., Destyni R., and Jennifer L, . Jullian H, Destyni R. , and Jennifer L, have reviewed the powerpoint within 24 hours. Submit documentation of CBI, and FBI, for staff members Jullian H., Destyni R. and Jennifer L with written response to Specialist. Correct by 12/11/2023

Corrected Corrected by Dec 11, 2023

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

Violation

Reviewed 6 staff files and observed Nicole V. to be missing current Shaken Baby/ Abusive Head Trauma Certificate. (hired 11/21/2023 Expired 9/26/2023) Correction: Obtain current Shaken Baby/ Abusive Head Trauma Certificate and maintain in staff file. Correct prior to submitting for approval of license. Correct by 12/11/2023

Corrected Corrected by Dec 11, 2023

Marked corrected in the state record.

Violation

Reviewed 6 staff files and observed Nicole V, Kayla S, Jillian H, Destyni R, and Jennifer L. and were missing Trails clearance letters. Correction: All individuals requiring a background check must review Navigating the Background Check Investigation Unit's (BIU) Webpage powerpoint. Submit verification that staff members Nicole V, Kayla S, Jillian H, Destyni R, and Jennifer L

Open Not marked corrected in the state record

Category: background checks. Open / not marked corrected.