110-300-0186(1) · An early learning provider must obtain written instructions (the individual care plan) from the child's health care provider and parent or guardian when caring for a child with a known food allergy or special dietary requirement due to a health condition. The individual care plan pursuant to WAC 110-300-0300 must: (a) Identify foods that must not be consumed by the child and steps to take in the case of an unintended allergic reaction; (b) Identify foods that can substitute for allergenic foods; and (c) Provide a specific treatment plan for the early learning provider to follow in response to an allergic reaction. The specific treatment plan must include the: (i) Names of all medication to be administered; (ii) Directions for how to administer the medication; (iii) Directions related to medication dosage amounts; and (iv) Description of allergic reactions and symptoms associated with the child's particular allergies.

1) There is a child with a food allergy that attends the child care. Provider does not have written instructions from the child's health care provider regarding the food allergy as required. The individual care plan completed by the parent is on file, but is not complete as it doesn't provide a specific treatment plan for the early learning provider to follow in response to an allergic reaction and there are no directions for how to administer the medication. The specific food the child is allergic to was observed on site. Correction

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110-300-0215(3) · Medication administration. An early learning provider must not give medication to any child without written and signed consent from that child's parent or guardian, must administer medication pursuant to directions on the medication label, and using appropriate cleaned and sanitized medication measuring devices.

3) There was no medication authorization on file for a child's emergency medication. Correction WAC/RCW Disputed Date Disputed Date 110-300-0165(2)(a) Serious 02/28/2024 02/29/2024

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110-300-0165(2)(a) · An early learning provider must take steps to prevent hazards to children including, but not limited to: (a) Making inaccessible to infants and toddlers any equipment, material, or objects that may pose a risk of choking, aspiration, or ingestion. For the purposes of this section, equipment, material, or objects that have a diameter or overall dimension of one and three-quarter inches or less are considered items that may pose a risk of choking, aspiration, or ingestion. Small parts from larger equipment, material, or objects that have a diameter or overall dimension of one and three-quarter inches or less, that may become detached from the larger equipment, materials, or object are also considered items that may pose a risk of choking, aspiration, or ingestion;

2)a) There were a few small toys and legos in a tray on the shelf in the bedroom/playroom that were accessible to children under age 3. 2)b) The window blinds in the kitchen do not have pull cords, but they are the type with exposed inner cords that can be pulled out to form a loop. It has been determined that this type of window blinds is not permitted in licensed space. 2)c) There were multiple cords in one of the drawers under the coffee bar that were accessible to children as the drawers were not secured in any way. 2)c) There was an electrical cord plugged in to an outlet on the deck near the railing. The cord was accessible to children in care. 2)c) There was a beaded string up on the wall with several strings hanging from it, and children's artwork clipped at the ends of the strings. This was within reach of children and could be pulled down to pose a hazard of strangulation.

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110-300-0165(2)(b) · An early learning provider must take steps to prevent hazards to children including, but not limited to: (b) Eliminating and not using in the licensed space, pursuant to RCW 43.216.380, any window blinds or other window coverings with pull cords or inner cords capable of forming a loop and posing risk of strangulation to children; (i) Window blinds and other window coverings that have been manufactured or properly retrofitted in a manner that eliminates the formation of loops posing a risk of strangulation are allowed; and (ii) A window covering must not be secured to the frame of a window or door used as an emergency exit in a way that would prevent the window or door from opening easily;

2)a) There were a few small toys and legos in a tray on the shelf in the bedroom/playroom that were accessible to children under age 3. 2)b) The window blinds in the kitchen do not have pull cords, but they are the type with exposed inner cords that can be pulled out to form a loop. It has been determined that this type of window blinds is not permitted in licensed space. 2)c) There were multiple cords in one of the drawers under the coffee bar that were accessible to children as the drawers were not secured in any way. 2)c) There was an electrical cord plugged in to an outlet on the deck near the railing. The cord was accessible to children in care.

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110-300-0165(2)(d) · An early learning provider must take steps to prevent hazards to children including, but not limited to: (d) Making inaccessible to children plastic bags and other suffocation hazards;

2)a) There were a few small toys and legos in a tray on the shelf in the bedroom/playroom that were accessible to children under age 3. 2)b) The window blinds in the kitchen do not have pull cords, but they are the type with exposed inner cords that can be pulled out to form a loop. It has been determined that this type of window blinds is not permitted in licensed space. 2)c) There were multiple cords in one of the drawers under the coffee bar that were accessible to children as the drawers were not secured in any way. 2)c) There was an electrical cord plugged in to an outlet on the deck near the railing. The cord was accessible to children in care.

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110-300-0165(3)(c) · An early learning provider must take measures intended to prevent other hazards to children in care in early learning program space including, but not limited to: (c) Sheering, crushing, or pinching. Broken or cracked equipment, materials, and objects must be repaired, removed, or made inaccessible to children;

2)a) There were a few small toys and legos in a tray on the shelf in the bedroom/playroom that were accessible to children under age 3. 2)b) The window blinds in the kitchen do not have pull cords, but they are the type with exposed inner cords that can be pulled out to form a loop. It has been determined that this type of window blinds is not permitted in licensed space. 2)c) There were multiple cords in one of the drawers under the coffee bar that were accessible to children as the drawers were not secured in any way. 2)c) There was an electrical cord plugged in to an outlet on the deck near the railing. The cord was accessible to children in care.

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110-300-0166(4)(c)(ii)(iii)(Iv)(v)(vi)(vii) · For family home early learning programs: (c) Any window used as an emergency exit window must: (ii) Be designed to open from the inside of the room without the use of keys, tools, or special knowledge; (iii) Be easy to open to the full position; (iv) Have at least five point seven square feet of open area, except emergency exit windows on the ground floor which must have at least five square feet of open area; (v) Be at least 20 inches wide and at least 24 inches tall when fully opened; (vi) Have an interior sill height no more than 44 inches above the interior floor; and (vii) Have a place to land outside that is no more than 48 inches below the exterior window sill.

4)c)ii) The emergency exit window in the bedroom/playroom had a locking device in the window track that would require special knowledge to remove. 4)c)iii) The locking device secured to the window track prevented the emergency exit window in the bedroom/playroom from opening to the full position. Correction WAC/RCW Disputed Date Disputed Date 110-300-0170(3)(a) Serious 03/02/2024 02/29/2024

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To ensure a safe environment for children in care, an early learning provider must comply with the following fire safety requirements: (a) Combustible materials. (i) Combustible materials must be properly discarded pursuant to local jurisdictions, removed from the premises, or properly stored in closed metal containers specifically designed to hold such combustible materials. (ii) Combustible materials stored in a closed metal container must not be stored in the premises licensed space or any place that may be accessible to children in care. (iii) Combustible materials include, but are not limited to, lint, gasoline, natural gas, diesel, fuel, propane, rags soaked in combustible materials, oils, chemicals, or solvents.

2) The last fire safety inspection was in 2021. There was no documentation of an annual fire safety inspection for 2022 or 2023. 3)a) There was a propane tank on the unlicensed part of the deck that was accessible to children because the gate to the unlicensed part of the deck was not secured in any way to prevent child access. Correction WAC/RCW Disputed Date Disputed Date 110-300-0260(5) Serious 03/03/2024

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110-300-0260(5) · Saws, power tools, lawn mowers, toilet plungers, toilet brushes, and other maintenance and janitorial equipment must be inaccessible to children.

5) There were small screwdrivers, boxes of screws and nails, and other small tools in the drawers under the coffee bar in the licensed space. The drawers were not secured in any way to prevent child access.

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