110-300-0215(3)(a)(i) · 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.

0215(3)(a)(i) - Licensor emailed the evening prior to the five day deadline for correction verification on this citation to remind provider that correction was due on Monday 8/12/24. Licensor did not recieve updated status on WAC 0215(3)(a)(i). At original MV, licensor observed child to have an Epi Pen without any Rx box or prescription label. WAC is re-cited.

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110-300-0105(2) · Early learning providers and household members in a family home early learning program must complete and pass a department background check, pursuant to chapter 110-06 WAC.

0105(2) - Licensor observed chef with withdrawn background check still on site at health and safety recheck visit.

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110-300-0106(11) · Family home licensees, center directors, assistant directors, program supervisors, lead teachers, assistant teachers, and any other early learning providers counted in staff-to-child ratio, or who could potentially be counted in ratio, must be trained in first-aid and cardiopulmonary resuscitation (CPR). (a) Proof of training can be shown with a certification card, certificate, or instructor letter. (b) The first-aid and CPR training and certification must: (i) Be delivered in person and include a hands-on component for first aid and CPR demonstrated in front of an instructor certified by the American Red Cross, American Heart Association, American Safety and Health Institute, or other nationally recognized certification program; (ii) Include child and adult first-aid and CPR; and (iii) Infant first-aid and CPR, if applicable.

0106(10) - Per Merit, 8 staff missing blood and body fluids training. 0106(11) - Per Merit, 19 staff missing FA/CPR training. 0106(3) - Per Merit, 9 staff missing CCB training. Please ensure new staff complete by 90 day mark. Risk WAC/RCW

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110-300-0215(3)(a)(i) · 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.

0215(3)(a)(i) - Licensor observed an Epi Pen stored in an emergency backpack. The Epi Pen was not stored in a box with the prescription label for the medication. Risk WAC/RCW

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An early learning provider must take steps to prevent hazards to children including, but not limited to: (c) Making inaccessible to children straps, strings, cords, wires, or similar items capable of forming a loop around a child’s neck that are not used during supervised early learning program activities;

0165(2)(c) - Licensor observed electrical cord to be accessible and present in a way that would allow a loop to be formed around a child's neck in River room. Provided TA to teacher and director. Risk WAC/RCW

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110-300-0105(2) · Early learning providers and household members in a family home early learning program must complete and pass a department background check, pursuant to chapter 110-06 WAC.

0105(2) - Licensor observed two staff members to have withdrawn background check applications status. Licensor confirmed these staff members have recently been on site at the center. 0105(3) - Per Merit, many staff missing TB verification. Risk WAC/RCW

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110-300-0106(10) · Early learning providers who directly care for children must complete the prevention of exposure to blood and body fluids training that meets Washington state department of labor and industries' requirements prior to being granted a license or working with children. This training must be repeated pursuant to Washington state department of labor and industries regulations.

0106(10) - Per Merit, 8 staff missing blood and body fluids training. 0106(11) - Per Merit, 19 staff missing FA/CPR training. 0106(3) - Per Merit, 9 staff missing CCB training. Please ensure new staff complete by 90 day mark.

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110-300-0106(3) · License applicants, center directors, assistant directors, program supervisors, lead teachers, assistant teachers, and aides must complete the child care basics training as approved or offered by the department: (a) Prior to being granted a license; (b) Prior to working unsupervised with children; or (c) Within three months of the date this section becomes effective if already employed or being promoted to a new role.

0106(10) - Per Merit, 8 staff missing blood and body fluids training. 0106(11) - Per Merit, 19 staff missing FA/CPR training. 0106(3) - Per Merit, 9 staff missing CCB training. Please ensure new staff complete by 90 day mark.

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110-300-0291(1)(d) · An early learning provider must follow safe infant sleep practices when infants are napping or sleeping by following the current standard of American Academy of Pediatrics concerning safe sleep practices including SIDS/SUIDS risk reduction, including: (d) Sufficiently lighting the room in which the infant is sleeping to observe skin color;

0291(1)(d) - Raindrop room had lights turned down too low. It was a cloudy day and there was not enough light in the room to be able to observe a child's skin color while sleeping. WAC/RCW Correction Date Disputed Date Disputed 110-300-0106(12) Serious

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110-300-0106(12) · Early learning providers who prepare or serve food to children at an early learning program must obtain a current food worker card prior to preparing or serving food. Food worker cards must: (a) Be obtained through the local health jurisdiction, in person or online; and (b) Be renewed prior to expiring. 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.

0106(3) - Multiple staff need to complete the childcare basics training. 0106(8) - Multiple staff need to complete the safe sleep training. 0106(10) - 3 staff are missing BBP. 0106(11) - 2 staff are missing FA/CPR. 0106(12) - 11 staff are missing Food Handler Permit.

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110-300-0215(2) · Medication training. An early learning provider must not give medication to a child if the provider has not successfully completed: (a) An orientation about the early learning program’s medication policies and procedures; (b) The department standardized training course in medication administration that includes a competency assessment pursuant to WAC 110-300-0106(10) or equivalent training; and (c) If applicable, a training from a child’s parents or guardian (or an appointed designee) for special medical procedures that are part of a child’s individual care plan. This training must be documented and signed by the provider and the child’s parent or guardian (or designee).

Director was missing documentation of medication training. WAC/RCW Correction Date Disputed Date Disputed 110-300-0106(1) Long Term

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110-300-0106(1) · 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. Early learning providers licensed, working, or volunteering in an early learning program before the date this section becomes effective must complete the applicable training requirements of this section within three months of the date this section becomes effective unless otherwise indicated. State or federal rules may require health and safety training described under this chapter to be renewed annually. Early learning providers hired after the date this section becomes effective must complete the training requirements of subsections (4) through (10) of this section within three months of the date of hire and prior to working in an unsupervised capacity with children.

Staff with Initial STARSexemptions were missing documenation of training specified under WAC 110-300-0106. Staff were also missing documenation of BBP professional training. BBP is supposed to be completed yearly. WAC/RCW Correction Date Disputed Date Disputed 110-300-0106(10) Short Term

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110-300-0106(10) · Early learning providers who directly care for children must complete the prevention of exposure to blood and body fluids training that meets Washington state department of labor and industries' requirements prior to being granted a license or working with children. This training must be repeated pursuant to Washington state department of labor and industries regulations.

Staff with Initial STARSexemptions were missing documenation of training specified under WAC 110-300-0106. Staff were also missing documenation of BBP professional training. BBP is supposed to be completed yearly. WAC/RCW Correction Date Disputed Date Disputed 110-300-0106(4) Short Term

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110-300-0106(4) · Early learning providers must complete the recognizing and reporting suspected child abuse, neglect, and exploitation training as approved or offered by the department according to subsection (1) of this section. Training must include the prevention of child abuse and neglect as defined in RCW 26.44.020 and mandatory reporting requirements under RCW 26.44.030.

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110-300-0106(5) · Early learning providers must complete the emergency preparedness training as approved or offered by the department (applicable to the early learning program where they work or volunteer) according to subsection (1) of this section.

Staff with Initial STARSexemptions were missing documenation of training specified under WAC 110-300-0106. Staff were also missing documenation of BBP professional training. BBP is supposed to be completed yearly. WAC/RCW Correction Date Disputed Date Disputed 110-300-0106(7) Short Term

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110-300-0106(7) · Early learning providers must complete the serving children experiencing homelessness training as approved or offered by the department according to subsection (1) of this section.

Staff with Initial STARSexemptions were missing documenation of training specified under WAC 110-300-0106. Staff were also missing documenation of BBP professional training. BBP is supposed to be completed yearly. WAC/RCW Correction Date Disputed Date Disputed 110-300-0106(9) Short Term

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110-300-0106(9) · 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. Family home licensees, center directors, assistant directors, program supervisors, and lead teachers must complete the medication management and administration training as approved or offered by the department prior to giving medication to an enrolled child, or as indicated in subsecton (1) of this section.

Staff with Initial STARSexemptions were missing documenation of training specified under WAC 110-300-0106. Staff were also missing documenation of BBP professional training. BBP is supposed to be completed yearly. WAC/RCW Correction Date Disputed Date Disputed 110-300-0115(1) Long Term

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110-300-0115(1) · An early learning provider must establish a records system for themselves, household members, staff, and volunteers that complies with the requirements of this chapter. Early learning program staff records must be: (a) Verified by the licensee, center director, assistant director, or program supervisor; (b) Entered and maintained in the electronic workforce registry, if applicable. Paper records may be discarded once entered into the electronic workforce registry and confirmed by the department; (c) Updated to delete staff names from the electronic workforce registry when no longer employed at the early learning program; and (d) Kept on-site or in the program’s administrative office in a manner that allows the department to review the records.

MERIT is missing information for some staff. WAC/RCW Correction Date Disputed Date Disputed 110-300-0470(1) Short Term

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110-300-0470(1) · 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 have and follow a written emergency preparedness plan. The plan must be reviewed and approved by the department prior to when changes are made. Emergency preparedness plans must: (a) Be designed to respond to fire, natural disasters, and other emergencies that might affect the early learning program; (b) Be specific to the early learning program and able to be implemented during hours of operation; (c) Address what the provider would do if the provider has an emergency and children may be left unsupervised; (d) Address what the early learning program must do if parents are not able to get to their children for up to three days; (e) Must follow requirements in chapter 212-12 WAC , Fire marshal standards, as now or hereafter amended and the state fire marshal's office requirements if a center early learning program; (f) Be reviewed at program orientation, annually with all early learning program staff with documented signatures, and when the plan is updated; (g) Be reviewed with parents or guardians when a child is enrolled and when the plan is updated.

Staff did not have documentation of signing off on reviewing the Disaster Plan yearly.

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