7.707.931.G · All outdoor areas where children may pass or play shall be kept free of animal contamination. All animal wastes must be promptly removed and placed in a lidded container or otherwise inaccessible to children.

Two piles of feces accessible to children. Correction: Make all outdoor areas where children pass or play free of animal contamination. Correct by 07/20/2023

Corrected Corrected by Jul 20, 2023

Marked corrected in the state record.

7.707.32.A.4 · Prior to issuance of the license, the licensee and primary provider must complete:A State Department approved training in Standard Precautions that meets current Occupational Safety and Health Administration (OSHA) requirements prior to working with children. This training must be renewed annually and may be counted towards ongoing training requirements. This Standard Precautions training can be included as part of the Pre-Licensing training, in which case the total number of hours for Pre-licensing training required in 7.707.A1 is increased to sixteen (16) clock hours, and Standard Precautions training may count as no more than one (1) hour of the sixteen (16) clock hours; and,

Reviewed provider file and observed missing documentation of current Standard Precautions training for Maria. Correction: Obtain documentation of Standard Precautions training for all providers. Correct by 07/20/2023

Corrected Corrected by Jul 20, 2023

Category: ratio. Marked corrected in the state record.

7.707.931.H · Window wells accessible to children must have covers that are in good condition and will protect children from falling into the window well. Window well covers must not prevent exiting from a basement window designated as the second exit.

Two window wells with out covers. Correction: Install window well covers on all window wells accessible to children. Correct by 07/20/2023

Corrected Corrected by Jul 20, 2023

Marked corrected in the state record.

7.707.934.C · Outdoor play space, including areas under decks must be free from safety hazards including, but not limited to, lawn mowers, tools, propane, gasoline, building scraps, and scrap metal. Gas grills with propane tanks must have a safety on/off knob on it.

Snow shovel and rake in backyard. Observed pile of wood scrap in back yard. Observed two plastic standing cabinets unlocked including but not limited to: 3 bottles of oil, Fast Orange cleaner, RainX, brake fluid, Fish Fertilizer, insecticide, Ant and Roach Killer, Windex, flying insect spray, all labeled Keep Out of Reach of Children, accessible to children. Correction: Make outdoor play space free from all safety hazards. Correct by 07/20/2023

Corrected Corrected by Jul 20, 2023

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

7.707.331.G.1 · In the large family child care home, the substitute for the: Primary provider must be equally qualified, as specified in Section 7.707.31, C, to provide care and supervision of children in the absence of the primary provider; and,

Observed Maria to not be on premises at time of arrival of inspection. Observed two persons caring for children Celina and Marissa. Reviewed Celina and Marissa's file and observed neither to be equally qualified as a large family child care provider as specified in section 7.707.31.C. Identified that Marissa works as an aide to Marrissa and Celina was working as a substitute for Maria. Correction: All substitutes for the primary provider must be equally qualified as specified in Section 7.707.31.C. Corrected at time of visit, Maria returned to the home, 07/20/2023. Correct by 07/20/2023

Corrected Corrected by Jul 20, 2023

Category: supervision. Marked corrected in the state record.

7.701.33.J.1.a.b.c · 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-aged child care facilities, family child care homes, and qualified exempt provider homes: a. State criminal history check b. State sex offender registry check c. State abuse and neglect registry check

Reviewed provider and 2 staff files and observed missing documentation of out of state affidavit for: Maria, Celina, and Marissa. Correction: Obtain documentation of out of state affidavit for all staff. Correct by 07/20/2023

Corrected Corrected by Jul 20, 2023

Category: supervision. Marked corrected in the state record.

7.707.34.B.1 · Employees and substitutes for the primary provider, for fourteen (14) days (112 hours) or more per calendar year must complete: Verification of current certification of First Aid and CPR for all ages of children;

Reviewed 2 staff files and observed missing documentation of First Aid CPR training for Marissa. Identified Marissa works as an aide with Maria. Correction: Obtain documentation of First Aid and CPR training for all employees and substitutes. Correct by 07/20/2023

Corrected Corrected by Jul 20, 2023

Category: recordkeeping. Marked corrected in the state record.

7.707.34.B.3 · Employees and substitutes for the primary provider, for fourteen (14) days (112 hours) or more per calendar year must complete: Verification of current State Department approved medication administration training; and

Reviewed 2 staff files and observed missing documentation of Medication Administration training for Marissa. Identified that Marissa works as an aide to Maria. Correction: Obtain documentation of medication administration training for all employees. Correct by 07/20/2023

Corrected Corrected by Jul 20, 2023

Category: ratio. Marked corrected in the state record.

7.707.923.A · All hazardous items and materials must be inaccessible to children including, but not limited to, FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ office supplies, matches, plastic bags, cleaning and laundry materials, medicines, 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.

On main floor observed 3 paint cans of paint and one container of spackeling labeled Keep Out of Reach of Children, accessible to children. Correction: Make all hazardous items inaccessible to children. Corrected at time of visit, Maria moved items making inaccessible to children 07/20/2023. No response is necessary. Correct by 07/20/2023

Corrected Corrected by Jul 20, 2023

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

7.707.32.A.7 · Prior to issuance of the license the licensee and primary provider must complete: The State Department approved course of training for medication administration.

Reviewed Provider file-Maria and observed missing documentation of State Department approved training for Medication Administration. Correction: Obtain documentation of State Department approved course for training for Medication Administration. Send verification of training with written response. Correct by 07/20/2023

Corrected Corrected by Jul 20, 2023

Category: ratio. Marked corrected in the state record.

7.707.32.A.9 · . Effective December 31, 2016, each provider or staff member responsible for the collection, review, and maintenance of the child immunization records must complete the Colorado Department of Public Health and Environment (CDPHE) immunization course within thirty (30) calendar days of employment. This training must be renewed annually and may count towards ongoing training requirements.

Reviewed provider file and observed missing documentation of immunization training for Maria. Correction: Obtain documentation of immunization training for provider. Correct by 07/20/2023

Corrected Corrected by Jul 20, 2023

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

7.707.71.A.1.c · At the time of admission each child's file contains:Documentation of immunization status or exemption, including month and year each immunization was administered. Immunizations must be updated and recorded as specified on the certificate of immunization or alternate certificate of immunization as supplied and approved by the FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ Colorado Department of Public Health and Environment. Colorado law requires that proof of immunization be provided prior to the first day of admission.

Reviewed 11 children's files and observed missing immunization for CH 8, 9, and 11. Observed immunization on non approved state form for: CH 3, 6, and 10. Correction: Obtain current immunization for all children on approved state form. Correct by 07/20/2023

Corrected Corrected by Jul 20, 2023

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

7.707.71.A.2 · Within thirty (30) days after admission, and within thirty (30) days following the expiration date, the parent or guardian 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 practitioner. The statement of the child's current health statusmust 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 statementsmust be kept at the licensed child care home.

Reviewed 11 children's files and observed CH 2, 3, 4, 5 ,8, 9, 10, and 11 to be missing current medical statement. Correction: Obtain documentation of current medical statement for all children within 30 days of admission or following the expiration date. Correct by 08/20/2023

Corrected Corrected by Aug 20, 2023

Category: ratio. Marked corrected in the state record.

7.707.331.D · Parents or guardians must be notified each time a substitute is used to provide supervision of all children in care in the absence of the primary provider.

Observed provider not at home at time of inspection. Observed no notification to parents that substitute was used to provide supervision of the children in absence of the primary provider. Correction: Parents and guardians must be notified each time a substitute is used. Correct by 07/21/2023

Corrected Corrected by Jul 21, 2023

Category: supervision. Marked corrected in the state record.

7.707.34.A.1 · Any employee whose activities involve the care or supervision of children; or who has unsupervised access to children must complete: A fingerprint based criminal background record check as required at FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ section 7.701.33 and,

Observed Celina caring for children, observed no fingerprint based criminal background check record for Celina. Correction: Submit and obtain CBI and FBI background checks prior to caring for children. All individuals requiring a background check must review Navigating the Background Check Investigation Unit's (BIU) Webpage Powerpoint. Submit verification that Celina has reviewed the Powerpoint with in 24 hours. Submit documentation of FBI, clearance letters for Celina with written response to Specialist. Correct by 07/20/2023

Corrected Corrected by Jul 20, 2023

Category: supervision. Marked corrected in the state record.

7.707.34.A.2 · Any employee whose activities involve the care or supervision of children; or who has unsupervised access to children must complete: The State Department mandated automated system background check for child abuse and neglect as required at Section 7.701.32.

Observed Celina caring for children and observed no Trails background checks for Celina. Correction: Obtain documentation of TRAILS background check prior to caring for children. All individuals requiring a background check must review Navigating the Background Check Investigation Unit's (BIU) Webpage Powerpoint. Submit verification that Celina has reviewed the Powerpoint within 24 hours. Submit documentation of TRAILS brackground check for Celina with written response to Specialist. Correct by 07/20/2023

Corrected Corrected by Jul 20, 2023

Category: supervision. Marked corrected in the state record.