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.

The Individual Health Care Plan and Medication Form is signed and dated 12/2021 but blank. Page 2-The Allegy/Intolerance Statement has no information documednted on it in the Food Allergy area, Page-3 at the top of the page where it reads: Allergy To: is blank, and for medications/actions to be taken on the lower part of the paper it is blank (no medications specified), Medication form has no start or end date. Epipen appears to be expired as of December 2021. Correction

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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.

The Individual Health Care Plan and Medication Form is signed and dated 12/2021 but blank. Page 2-The Allegy/Intolerance Statement has no information documednted on it in the Food Allergy area, Page-3 at the top of the page where it reads: Allergy To: is blank, and for medications/actions to be taken on the lower part of the paper it is blank (no medications specified), Medication form has no start or end date. Epipen appears to be expired as of December 2021. Correction WAC/RCW Disputed Date Disputed Date 110-301-0186(3)(a)(b)(c )(i)(ii) Immediate

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110-301-0186(3)(a)(b)(c · If a child suffers from an allergic reaction, the school-age provider must immediately: (a) Administer medication pursuant to the instructions in that child's individual care plan; (b) Contact 911 whenever epinephrine or other lifesaving medication has been administered; and (c) Notify the parents or guardians of a child if it is suspected or appears that any of the following occurred, or is occurring: (i) The child is having an allergic reaction; or (ii) The child consumed or came in contact with a food identified by the parents or guardians that must not be consumed by the child, even if the child is not having or did not have an allergic reaction.

The Individual Health Care Plan and Medication Form is signed and dated 12/2021 but blank. Page 2-The Allegy/Intolerance Statement has no information documednted on it in the Food Allergy area, Page-3 at the top of the page where it reads: Allergy To: is blank, and for medications/actions to be taken on the lower part of the paper it is blank (no medications specified), Medication form has no start or end date. Epipen appears to be expired as of December 2021. Correction WAC/RCW Disputed Date Disputed Date 110-301-0186(4) Serious

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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. 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.

The Individual Health Care Plan and Medication Form is signed and dated 12/2021 but blank. Page 2-The Allegy/Intolerance Statement has no information documednted on it in the Food Allergy area, Page-3 at the top of the page where it reads: Allergy To: is blank, and for medications/actions to be taken on the lower part of the paper it is blank (no medications specified), Medication form has no start or end date. Epipen appears to be expired as of December 2021. Correction WAC/RCW Disputed Date Disputed Date 110-301-0215(3) Serious

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110-301-0215(3) · Medication administration. A school-age 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 must use cleaned and sanitized medication measuring devices.

1 staff member is missing Basic STARS or the Medication Management Training. Medication authorization forms are not completely filled out in complaince of the WAC. Medication is expired. Correction WAC/RCW Disputed Date Disputed Date 110-301-0215(3)(a)(i)(A)(B)(C)(D)(E) Serious

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110-301-0215(3)(a)(i)(A)(B)(C)(D)(E) · 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.

1 staff member is missing Basic STARS or the Medication Management Training. Medication authorization forms are not completely filled out in complaince of the WAC. Medication is expired.

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110-301-0106(9)(a)(b)(i)(ii) · Program directors, site directors, lead teachers, assistant teachers, and any other school-age 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; and (ii) Include child and adult first-aid and CPR.

Staff were missing documenation of training and/or documentation in MERIT of certifcation. 1 staff member does not have Initial Training within the 3 month time frame. 1 staff missing documentation of trainings specified under 110-300-0106 (4-7) via the DCYF Portal. 1 staff missing documenation of CPR/First Aid. Documentation of training needs to be reflected in MERIT. Several staff missing documentation of BBP training.

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