2.312.H · Prior to working with children the primary provider, applicant 2, the equally qualified provider, qualified substitutes, and all staff members must complete a Department approved training about child abuse prevention, including common symptoms and signs of child abuse how to report, where to report, and when to report suspected or known child abuse or neglect within thirty (30) calendar days of employment. This training must be renewed annually.

Provider having an expired child abuse prevention training. Correction: Obtain documentation of current child abuse prevention training and add to file. Correct by 10/02/2024

Corrected Corrected by Oct 2, 2024

Category: recordkeeping. 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 9 children's files and observed 2 files having an expired health statement. Correction: Obtain documentation of current health statements and add to file. Correct by 11/02/2024

Corrected Corrected by Nov 2, 2024

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 guardian(s). The authorization must be notarized if required by the local hospital, clinic, or emergency health care facility;

Reviewed 9 children's files and observed 6 files having an expired emergency medical authorization. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ Observed 1 file to be missing an emergency medical authorization. Correction: Obtain documentation of current emergency medical authorization and add to file. Correct by 10/02/2024

Corrected Corrected by Oct 2, 2024

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

2.337.D.2 · All outdoor play areas shall frequently be surveyed and must be kept safe and free from hazardous materials or debris that could cause harm to children.

A window on the family child care home having broken glass with shards of glass accessible to children in the outdoor play space posing a potential safety hazard. Correction: All outdoor play areas shall frequently be surveyed and must be kept safe and free from hazardous materials or debris that could cause harm to children. Correct by 10/02/2024

Corrected Corrected by Oct 2, 2024

Category: physical safety. 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 9 children's files and observed 1 file to be missing an immunization record. Correction: Obtain documentation of current immunization record and add to file. Correct by 10/02/2024

Corrected Corrected by Oct 2, 2024

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 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 FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ 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 9 children's files and observed 1 file to be missing a current health statement. Correction: Obtain documentation of current health statement and add to file. Correct by 11/02/2024

Corrected Corrected by Nov 2, 2024

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.

At the time of inspection, provider to be missing a record of all emergency drills held over the past 12 months. Correction: Ensure that a record of all emergency drills held over the past 12 months is completed and maintained in files. Correct by 10/02/2024

Corrected Corrected by Oct 2, 2024

Category: recordkeeping. Marked corrected in the state record.

2.321.B.8 · All medications in the family child care home, except those medications specified in the Department-approved medication administration training as emergency medications, must be locked and inaccessible to children, but available to the primary provider, applicant 2, equally qualified provider, qualified substitute, or staff members trained in administering medication.

Medications to be accessible to children in an unlocked cabinet on on counter in the kitchen. Correction: All medications in the family child care home, except those medication specified in the department-approved medication administration training as emergency medications, must be locked an inaccessible to children. ***CORRECTED AT TIME OF VISIT*** Provider locked cabinet making medications inaccessible to children. Correct by 10/02/2024

Corrected Corrected by Oct 2, 2024

Category: ratio. 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.

Broken wooden planks on wood deck to the entrance of the home posing a potential safety hazard. Correction: The premises of the family child care home must be kept safe and free from hazards to the health at all times. Correct by 10/02/2024

Corrected Corrected by Oct 2, 2024

Category: health medication. 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.”

Approximately 9 diaper wipes labeled keep out of the reach of children accessible to children on kitchen table posing a potential safety hazard. Correction: Make all hazardous items inaccessible to children. ***CORRECTED AT TIME OF VISIT*** Provider moved diaper wipes making them inaccessible to children. Correct by 10/02/2024

Corrected Corrected by Oct 2, 2024

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

2.337.D.3 · Outdoor play space, including areas under decks must be free from safety hazards including, but FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ not limited to, lawn mowers, tools, propane, gasoline, building scraps, and scrap metal.

A water hose strung along fence accessible to children on the outdoor play space, and a yard rake accessible to children on ground next to fence on the outdoor play space all posing a potential safety hazard. Correction: 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. ***CORRECTED AT TIME OF VISIT*** Provider moved hazardous items making them inaccessible to children. Correct by 10/02/2024

Corrected Corrected by Oct 2, 2024

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

2.124.A.1.d · 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: Any allegation of physical, sexual, or emotional abuse or neglect to a child that results in a mandatory report to law enforcement or a county department of FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ human or social services agency, or the child abuse reporting hotline as described in section 19-3-304, C.R.S.

Identified through providers statement that licensing was not notified within the required time frames regarding a reportable incident. Correction: Ensure the provider notifies licensing of a reportable incident within the required time frame. Correct by 10/02/2024 Stage II Licensing Concern : Facility failed to report an incident within the time frames as required by statute and licensing regulations. - FOUNDED

Corrected Corrected by Oct 2, 2024

Category: ratio. Marked corrected in the state record.

2.126.B · Pursuant to section 19-3-304, C.R.S., any caregiver or staff member in a child care facility who has reasonable cause to know or suspect that a child has been subjected to abuse or neglect or who has observed the child being subjected to circumstances or conditions that would reasonably result in abuse or neglect shall immediately upon receiving such information report or cause a report to be made of such fact to the county department of human or social services, the local law enforcement agency, or through the child abuse hotline reporting system as set forth in section 26-5-111, C.R.S.

Identified through providers statement that a reportable incident was not reported within the required time frames. Correction: Ensure the facility reports all reportable incidents within the required time frame. Correct by 10/02/2024 Stage II Licensing Concern : Provider was over ratio at the time of incident. - FOUNDED

Corrected Corrected by Oct 2, 2024

Marked corrected in the state record.

2.309.A.4 · When more than eight (8) children are present, a second staff member that is qualified as an applicant 2, equally qualified provider, qualified substitute, staff member, or staff aide is required.

Identified through providers statement that large family child care home does not maintain a daily attendance sign in/ sign out sheet for each child. Identified provider to have 9 children enrolled at time of inspection. Correction: When more than 8 children are present, a second staff member that is qualified as an applicant 2, equally qualified provider, qualified substitute, staff member, or staff aide is required. Correct by 10/02/2024

Corrected Corrected by Oct 2, 2024

Marked corrected in the state record.

2.318.D.1 · The following records must be kept and maintained in the files at the family child care home for three (3) years after the family child care home closes its license or stops providing care under its license; a child leaves the care of the family child care home or a staff member or volunteer terminates employment or volunteerism at the family child care home: A daily attendance sign in/sign out sheet for each child, including the time the child arrives at and departs from the family child care home;

Identified through providers statement that large family child care home does not maintain a daily attendance sign in/ out sheet for each child. Identified provider to have 9 children enrolled at time of inspection. Correction: Ensure a daily attendance sign in/ sign out sheet for each child, including the time the child arrives at and departs from the family child care home, is completed and maintained in files. Correct by 10/02/2024 ________________________________________________ Stage II Licensing Concern : Provider did not know activity of children at the time of incident. - UNFOUNDED ________________________________________________

Corrected Corrected by Oct 2, 2024

Category: recordkeeping. 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,

Provider having an expired standard precautions training. Correction: Obtain documentation of current standard precautions training and send verification to specialist with written response. Correct by 10/04/2023

Corrected Corrected by Oct 4, 2023

Category: ratio. 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.

Provider having an expired medication administration training. Correction: Obtain documentation of current medication administration training and send verification to specialist with written response. Correct by 10/04/2023

Corrected Corrected by Oct 4, 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.

Provider having an expired immunization training. Correction: Obtain documentation of current immunization training and send verification to specialist with written response. Correct by 10/04/2023

Corrected Corrected by Oct 4, 2023

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

7.707.51.A · An admission record must be completed for each child prior to or at the time of the child's admission and updated annually, unless otherwise specified in these rules. The admission record must include:

Identified through providers statement that 7 children are enrolled. Observed 1 child to be missing a complete admission record. Correction: An admission record must be completed for each child prior to or at the time of the child's admisson and updated annually. Correct by 10/04/2023

Corrected Corrected by Oct 4, 2023

Category: recordkeeping. 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 Colorado Department of Public Health and Environment. Colorado law requires that proof of immunization be provided prior to the first day of admission.

Reviewed 7 children's files and observed 2 files needing an immunization record transferred to the state approved form and 3 children's files to be missing an immunization record. Correction: Obtain and transfer documentation of current children's immunization records and add to file. Correct by 10/04/2023

Corrected Corrected by Oct 4, 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 7 children's files and observed 3 files to be missing a current health statement. Correction: Obtain documentation of current health statements and add to file. Correct by 11/04/2023

Corrected Corrected by Nov 4, 2023

Category: ratio. Marked corrected in the state record.

7.707.71.B.1 · The provider must obtain written authority to arrange for emergency medical care for each child. Written authorization to obtain emergency medical care must be on file prior to or on the first day of admission and must be re-authorized annually.

Reviewed 7 children's files and observed 2 files to be missing a dated emergency medical authorization. Observed 1 file to be missing an emergency medical authorization. Observed 1 file having an expired emergency medical authorization. Correction: Obtain documentation of current emergency medical authorization and add to file. Correct by 10/04/2023

Corrected Corrected by Oct 4, 2023

Marked corrected in the state record.

7.707.91.F · All garbage and other wastes must be stored in a manner that is inaccessible to children and disposed of in a manner that does not constitute a health hazard or nuisance.

2 garbage cans to be missing lids accessible to children in an unlocked cabinet in the kitchen. Correction: All garbage and other wastes must be stored in a manner that is inaccessible to children. Correct by 10/04/2023

Corrected Corrected by Oct 4, 2023

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

7.707.91.J · Any provider's, employee's, substitute's, volunteer's, and/or visitor's animal(s) and/or fish that are dangerous, and/or pose a potential threat to a child's safety or health must be confined in a place away from the child care area and inaccessible to children. The provider's animals must be vaccinated as required by state law and local ordinance, and proof of vaccination must be available for review by the licensing specialist.

Identified provider to have 5 animals in the residence. Observed 3 animals having an expired vaccination FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ record. Correction: Obtain documentation of current animal vaccination records and send verification to specialist with written response. Correct by 10/04/2023

Corrected Corrected by Oct 4, 2023

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