110-301-0186(1)(a)(b)(c)(i)(ii)(iii)(iv) · A school-age 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 110-301-0300 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 school-age 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)a)b)c) The individual care plans for children with food allergies did not have a clear and specific treatment plan for the staff to follow in response to an allergic reaction. Two children had more than one medication intended to treat the food allergies but it is not clear what symptoms would necessitate which medication. Some of the individual care plan forms did not have the medications listed or the instructions for giving those medications. The individual care plans were not signed by the health care provider and there were no separate, written instructions from the health care provider. 2) One medication that appears to be prescribed for a child's food allergies expired last month.

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110-301-0186(4) · A school-age provider must review each child's individual care plan information for food allergies prior to serving food to children.

1)a)b)c) The individual care plans for children with food allergies did not have a clear and specific treatment plan for the staff to follow in response to an allergic reaction. Two children had more than one medication intended to treat the food allergies but it is not clear what symptoms would necessitate which medication. Some of the individual care plan forms did not have the medications listed or the instructions for giving those medications. The individual care plans were not signed by the health care provider and there were no separate, written instructions from the health care provider. 2) One medication that appears to be prescribed for a child's food allergies expired last month. 4) There were three individual care plans that did not have documentation that staff have reviewed them. WAC/RCW Correction Date Disputed Date Disputed 110-301-0210(1)(2)(a)(b)(c) Long Term 03/15/2024

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110-301-0210(1)(2)(a)(b)(c) · (1) Before attending a school-age program, a child must be vaccinated against or show proof of acquired immunity for the vaccine-preventable disease, pursuant to chapter 246-105 WAC. A school-age provider may accept children without proof of vaccinations or immunity as otherwise indicated in this section. '(2) Pusuant to WAC 246-105-050, a school-age provider must receive for each enrolled child: (a) A current and complete DOH-approved certificate of immunization status (CIS) form or an alternative in lieu of CIS pursuant to WAC 246-105-050(3); (b) A department approved certificate of exemption (COE) form, if applicable; or (c) A current immunization record from the Washington state immunzation information system (WA IIS).

2)a) One child's immunization record is incomplete. WAC/RCW Correction Date Disputed Date Disputed 110-301-0215(3)(a)(i)(A)(B)(C)(D)(E) Serious 03/14/2024

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110-301-0215(3)(a)(i)(A)(B)(C)(D)(E) · 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. A school-age 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 the 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 administration and storage.

3)a)i) The prescription medications for two children in care did not have clear medication authorizations for those specific medications. The medication authorizations that were on file listed three different medications on them that were oral, injected, and inhaled and did not have clear information about the medical need or dosage for each medication. 3)a)ii) There was a nonprescription oral medication for a child that was not accompanied with a medication authorization form with the expiration date, medical need, dosage, age, and length of time to give the medication. This medication was listed on an authorization form that had two other prescription medications listed. WAC/RCW Correction Date Disputed Date Disputed 110-301-0215(3)(a)(ii)(A)(B) Serious 03/14/2024

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110-301-0215(3)(a)(ii)(A)(B) · A school-age provider must administer medication to children in care as follows: (ii) Nonprescription oral medication. Nonprescription (over-the-counter) oral medication brought to the school-age 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. A school-age provider must follow the instructions on the label or the parent or guardian 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.

3)a)i) The prescription medications for two children in care did not have clear medication authorizations for those specific medications. The medication authorizations that were on file listed three different medications on them that were oral, injected, and inhaled and did not have clear information about the medical need or dosage for each medication. 3)a)ii) There was a nonprescription oral medication for a child that was not accompanied with a medication authorization form with the expiration date, medical need, dosage, age, and length of time to give the medication. This medication was listed on an authorization form that had two other prescription medications listed.

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110-301-0186(2) · A school-age provider must arrange with the parents or guardians of a child in care to ensure the school-age program has the necessary medication, training, and equipment to properly manage a child's food allergies.

1)a)b)c) The individual care plans for children with food allergies did not have a clear and specific treatment plan for the staff to follow in response to an allergic reaction. Two children had more than one medication intended to treat the food allergies but it is not clear what symptoms would necessitate which medication. Some of the individual care plan forms did not have the medications listed or the instructions for giving those medications. The individual care plans were not signed by the health care provider and there were no separate, written instructions from the health care provider. 2) One medication that appears to be prescribed for a child's food allergies expired last month. 4) There were three individual care plans that did not have documentation that staff have reviewed them.

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