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.

It was observed that a care plan was dated from 2023. 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.

It was observed that a child had an EpiPen onsite but was not stored with the prescription label. It was observed that toothpaste and hand sanitizer was accessible to children in the Pond Room. Risk WAC/RCW

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110-300-0215(3)(c) · Medication must be stored and maintained as directed on the packaging or prescription label, including applicable refrigeration requirements. An early learning provider must comply with the following additional medication storage requirements: (i) Medication must be inaccessible to children; (ii) Controlled substances must be locked in a container or cabinet which is inaccessible to children; (iii) Medication must be kept away from food in a separate, sealed container; and (iv) External medication (designed to be applied to the outside of the body) must be stored to provide separation from internal medication (designed to be swallowed or injected) to prevent cross contamination.

It was observed that a child had an EpiPen onsite but was not stored with the prescription label. It was observed that toothpaste and hand sanitizer was accessible to children in the Pond Room.

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110-300-0230(2)(b) · A first-aid kit must: (b) Be inaccessible to children

110-300-0230(2)(b) First Aid Backpack was accessible to children in care.

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