2.311.A.14 · Subsequent health evaluations for the primary provider, applicant 2, and children residing in the home who are less than ten (10) years of age must be obtained every two (2) years or as required in a written plan signed by a licensed physician or other health care provider. A new family member and/or a new resident of the home must obtain a health evaluation form signed and dated by a licensed physician or other health care provider within thirty (30) days from the date the individual began living in the home.

Provider having an expired health statement. Correction: Obtain documentation of current health statement and send verification to specialist with written response. Correct by 09/27/2024

Corrected Corrected by Sep 27, 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; FAX 303-866-4453 Phone 303-866-5948 ________________________________________________

Reviewed 6 children's files and observed 3 files having an expired emergency medical authorization. Correction: Obtain documentation of current emergency medical authorization and add to file. Correct by 08/27/2024

Corrected Corrected by Aug 27, 2024

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 6 children's files and observed 3 files having an immunization record not transferred to the state approved form. Observed 1 file to be missing an immunization record. Correction: Obtain documentation and transfer immunizations to the state approved form and add to file. Correct by 08/27/2024

Corrected Corrected by Aug 27, 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 6 children's files and observed 1 file having an expired health statement. Correction: Obtain documentation of current health statement and add to file. Correct by 09/27/2024

Corrected Corrected by Sep 27, 2024

Category: health medication. 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.

Over the counter and prescription medications accessible to children in an unlocked cabinet in main floor hallway and unlocked cabinet on main floor in kitchen, and on main floor kitchen counter, FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ Correction: All medications in the family child care home, except those medications specified in the department- approved medication administration training and emergency medications, must be locked and inaccessible to children. ***CORRECTED AT TIME OF VISIT*** Provider locked medication in cabinet making them inaccessible to children. Correct by 08/27/2024

Corrected Corrected by Aug 27, 2024

Category: ratio. 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.”

Knives accessible to children on kitchen counter posing a potential safety hazard. Observed gallon sized zip lock bags accessible to children in unlocked drawer in the kitchen posing a potential safety hazard. Observed diaper wipes labeled keep out of the reach of children accessible to children on low shelf in nap room posing a potential safety hazard. Correction: Make all hazardous item inaccessible to children. ***CORRECTED AT TIME OF VISIT*** Provider moved items making them inaccessible to children. Correct by 08/27/2024

Corrected Corrected by Aug 27, 2024

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

2.336.C.2 · In rooms accessible to children, all electrical outlets and power strips must have protective covers, or safety outlets must be installed; all exposed light bulbs accessible to children in areas where children can play must have protective covers. Electrical cords must be in good condition and must not pose strangulation, falling, or tripping hazards. FAX 303-866-4453 Phone 303-866-5948 ________________________________________________

An electrical outlet to be missing protective covers accessible to children in the main floor living room, main floor dining room, main floor laundry room, and in the basement play room. Correction: In rooms accessible to children, all electrical outlets and power strips must have protective covers, or safety outlets must be installed. Correct by 08/27/2024

Corrected Corrected by Aug 27, 2024

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

2.337.B.1.a · All climbing equipment, sliding equipment, or equipment with attached platforms, eighteen (18) inches or higher must have resilient surfacing of at least six (6) inches in the use zone, see rule section 2.337(B)(3), surrounding the equipment.

Swing set with an attached slide accessible to children in backyard measuring over 18 inches placed on grass. Correction: All climbing equipment, sliding equipment, or equipment with attached platforms, 18 inches or higher must have a resilient surfacing of at least 6 inches in the use zone. Correct by 08/27/2024

Corrected Corrected by Aug 27, 2024

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

2.337.B.3.b · Preschool and school-age climbing equipment, sliding equipment, or equipment with attached platforms must have a six (6) foot use zone surrounding the equipment.

Swing set with attached slide accessible to children in backyard being placed next to fence with approximately 3 to 4 feet of use zone. Correction: Preschool and school- age climbing equipment, sliding equipment, or equipment with attached platforms must have a 6 foot use zone surrounding the equipment. Correct by 08/27/2024

Corrected Corrected by Aug 27, 2024

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

2.337.B.5 · All play equipment must be designed to guard against entrapment and strangulation. Swing sets and other outdoor play equipment must be correctly assembled, well maintained, and securely stabilized or anchored.

Swing set accessible to children to be placed on grass and not securely stabilized or anchored. Correction: Swing sets and other outdoor play equipment must be correctly assembled, well maintained, and securely stabilized or anchored. Correct by 08/27/2024

Corrected Corrected by Aug 27, 2024

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

7.707.32.A.10 · . Effective December 31, 2016 each provider, staff member or regular volunteer 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 annually and may count towards ongoing training requirements.

Provider having an expired shaken baby/ abusive head trauma training. Correction: Obtain documentation of current shaken baby/ abusive head trauma training and add to file. Correct by 09/06/2023

Corrected Corrected by Sep 6, 2023

Category: recordkeeping. 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 having and expired emergency medical authorization. Observed 1 file to be missing emergency medical authorization. Correction: Obtain documentation of current emergency medical authorization and add to file. Correct by 09/06/2023

Corrected Corrected by Sep 6, 2023

Marked corrected in the state record.

7.707.32.A.11 · . Effective December 31, 2016 each provider, staff member or regular volunteer must complete a department-approved training about child abuse prevention, including common symptoms and signs of child abuse within thirty (30) calendar days of employment. This training must be renewed annually and may count towards ongoing training requirements.

Provider having an expired child abuse prevention training. Correction: Obtain documentation of current child abuse prevention training and add to file. Correct by 09/06/2023

Corrected Corrected by Sep 6, 2023

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 add to file. Correct by 09/06/2023

Corrected Corrected by Sep 6, 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 09/06/2023

Corrected Corrected by Sep 6, 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 FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ 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 add to file. Correct by 09/06/2023

Corrected Corrected by Sep 6, 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:

1 child in care to be missing a complete admission record. Correction: An admission record must be completed for each child prior to or at the time of child's admission. Correct by 09/06/2023

Corrected Corrected by Sep 6, 2023

Category: recordkeeping. 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 2 files having an expired health statement. Observed 1 file to be missing a health statement. Correction: Obtain documentation of current children's health statements and add to file. Correct by 10/06/2023

Corrected Corrected by Oct 6, 2023

Category: ratio. 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 FAX 303-866-4453 Phone 303-866-5948 ________________________________________________ health evaluation form signed and dated by a licensed physician or other health professional.

1 child residing in the home having an expired health evaluation. Correction: Obtain documentation of current health evaluation an send verification to specialist with written response. Correct by 10/06/2023

Corrected Corrected by Oct 6, 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 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 1 file to be missing an immunization record. Correction: Obtain documentation of current immunization record and add to file. Correct by 09/06/2023

Corrected Corrected by Sep 6, 2023

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

7.707.71.C.5 · Medication must be stored in a locked cabinet, cupboard, or locked box so that it is inaccessible to children. If refrigeration is required, it must be stored in a leak- proof container in a designated area of the refrigerator separated from food.

Observed multiple medications stored in an unlocked cabinet in the kitchen accessible to children. Observed 1 bottle of prescription medication accessible to children on top of kitchen counter. Correction: Medication must be stored in a locked cabinet, cupboard, or locked box so that it is inaccessible to children. ***CORRECTED AT TIME OF VISIT*** Provider locked medications in a cabinet making them inaccessible to children. Correct by 09/06/2023

Corrected Corrected by Sep 6, 2023

Category: ratio. Marked corrected in the state record.

7.707.75.G · Safe Sleep Training for Family Child Care Staff All staff who work with infants must complete Department-approved safe sleep training prior to working with infants and on an annual basis.

Provider having an expired safe sleep training. Correction: Obtain documentation of current safe sleep training and add to file. Correct by 09/06/2023

Corrected Corrected by Sep 6, 2023

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

7.707.923.B · In rooms accessible to children, all electrical outlets and power strips must nave protective covers, or safety outlets must be installed; and all exposed light bulbs must have protective covers. Electrical cords must be in good condition and not posing a hazard, such as strangulation, falling or tripping.

Electrical outlets accessible to children in the following rooms to be missing protective covers : basement main play room, upstairs living room, upstairs entryway, upstairs dining room, upstairs bathroom. Correction: In rooms accessible to children, all electrical outlets and power strips must have protective covers. ***CORRECTED AT TIME OF VISIT*** Provider placed protective covers making electrical outlets inaccessible to children. Correct by 09/06/2023

Corrected Corrected by Sep 6, 2023

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

7.707.932.D · Portable climbing equipment over two feet (2') in height, whether indoor or outdoor, must be on a protective surfacing. No equipment can be placed on cement or grass.

A portable slide over 2 feet in height to be placed on grass on outdoor play space. Correction: Portable climbing equipment over 2 feet in height, whether indoor or outdoor, must be on a protective surfacing. ***CORRECTED AT TIME OF VISIT*** Provider moved portable slide to a locked shed making it inaccessible to children. Correct by 09/06/2023

Corrected Corrected by Sep 6, 2023

Category: physical safety. 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.

2 lawn mowers accessible to children in an unlocked shed on the outdoor play space posing a potential safety hazard. Correction: Make all hazardous items inaccessible to children. ***CORRECTED AT TIME OF VISIT*** Provider locked shed making hazardous items inaccessible to children. Correct by 09/06/2023

Corrected Corrected by Sep 6, 2023

Category: physical safety. 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, 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.

Cleaning solutions labeled keep out of reach of children accessible to children in an unlocked cabinet under kitchen sink and in an unlocked cabinet in laundry room. Observed Personal care bottles labeled keep out of reach of children accessible to children in multiple unlocked drawers and cabinets in the upstairs bathroom. Observed 2 boxes of tin foil and 2 boxes of cling wrap with a serrated edge accessible to children in an unlocked cabinet in the kitchen. Observed gallon sized zip lock bags and quart sized zip lock bags accessible to children in an unlocked cabinet in the kitchen. Correction: Make all hazardous items inaccessible to children. ***CORRECTED AT TIME OF VISIT*** Provider moved hazardous items to a locked drawer and cabinets making items inaccessible to children. Correct by 09/06/2023

Corrected Corrected by Sep 6, 2023

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