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;

Tamper-resistant (TR) round caps were observed in outlet covers that already had TR covers installed. Risk WAC/RCW

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110-300-0197(4) · Food must be stored as follows: (a) In original containers or in clean, labeled, dated, and airtight food grade containers, if appropriate. (b) Food not required to be refrigerated or frozen must not be stored directly on the floor; (c) In a manner that prevents contamination; (d) Food and food service items (such as utensils, napkins, and dishes) must not be stored in an area with toxic materials (such as cleaning supplies, paint, or pesticides); (e) Food that is past the manufacturer's expiration or “best served by” date must not be served to enrolled children; and (f) Raw meat must be stored in the refrigerator or freezer below cooked or ready to eat foods.

In one classroom, food stored in the refrigerator was missing labels indicating ownership or the date it was opened, and "veggi straws" were not stored in an airtight container.

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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.

Several individual care forms observed with the prescription medication did not contain all the necessary information. It is suggested to utilize the state-provided form to ensure comprehensive documentation. WAC/RCW Correction Date Disputed Date Disputed 110-300-0215(3)(a)(i) Serious

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110-300-0215(3)(a)(i) · Non-Compliances: This section of the Inspection Report lists non-compliances found during any licensing inspection. Information from this section will be reported to Child Care Check and be can be used to determine current and future licensing and enforcement actions. An early learning provider must administer medication to children in care as follows: (i) Prescription medication. Prescription medication must only be given to the child named on the prescription. Prescription medication must be prescribed by a health care professional with prescriptive authority for a specific child. Prescription medication must be accompanied with medication authorization form that has the medical need and the possible side effects of medication. Prescription medication must be labeled with: (A) A child's first and last name; (B) The date the prescription was filled; (C) The name and contact information of the prescribing health professional; (D) The expiration date, dosage amount, and length of time to give the medication; and (E) Instructions for the administration and storage.

110-300-0215(3)(a)(i), the prescription medication used for treating eczema observed in classroom #115 did not have an "end date" recorded on the form. 110-300-0215(3)(a)(ii), nonprescription oral medications such as stinging cream and ibuprofen tablets were observed in the first aid kit; acetaminophen 160mg in liquid form in red capsule was observed in the emergency backpack. No labels to whom the medication belonged were observed. WAC/RCW Correction Date Disputed Date Disputed 110-300-0215(3)(a)(ii) Serious

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110-300-0215(3)(a)(ii) · An early learning provider must administer medication to children in care as follows: (ii) Nonprescription oral medication. Nonprescription (over-the-counter) oral medication brought to the early learning program by a parent or guardian must be in the original packaging. (A) Nonprescription (over-the-counter) medication needs to be labeled with child's first and last name and accompanied with medication authorization form that has the expiration date, medical need, dosage amount, age, and length of time to give the medication. Early learning providers must follow the instructions on the label or the parent must provide a medical professional's note; and (B) Nonprescription medication must only be given to the child named on the label provided by the parent or guardian.

110-300-0215(3)(a)(i), the prescription medication used for treating eczema observed in classroom #115 did not have an "end date" recorded on the form. 110-300-0215(3)(a)(ii), nonprescription oral medications such as stinging cream and ibuprofen tablets were observed in the first aid kit; acetaminophen 160mg in liquid form in red capsule was observed in the emergency backpack. No labels to whom the medication belonged were observed. WAC/RCW Correction Date Disputed Date Disputed 110-300-0165(2)(d) Serious

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110-300-0165(2)(d) · Non-Compliances: This section of the Inspection Report lists non-compliances found during any licensing inspection. Information from this section will be reported to Child Care Check and be can be used to determine current and future licensing and enforcement actions. 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;

110-300-0165(2)(d), rolls of plastic bags were observed stored in the bathroom atop the dryer, accessible to children when using a step stool. 110-300-0165(3)(e), the blue rug observed in classroom #127 was rolled up at the edges, posing a tripping hazard.

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