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.

1 staff file (F.F) reviewed did not have documentation of a current BBP card. 2 staff files reviewed C.M and JS. had a food worker card from an unapproved company/organization. Risk WAC/RCW

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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.

1 staff file (F.F) reviewed did not have documentation of a current BBP card. 2 staff files reviewed C.M and JS. had a food worker card from an unapproved company/organization. Risk WAC/RCW

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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.

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110-300-0186(2) · An early learning provider must arrange with the parents or guardians of a child in care to ensure the early learning program has the necessary medication, training, and equipment to properly manage a child's food allergies.

Need to ensure that all required paperwork for children's individual plan is present and completly filled out (plan and medication form). Also need to ensure that required medication is present. Risk WAC/RCW

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110-300-0215(3) · Medication administration. An early learning 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 using appropriate cleaned and sanitized medication measuring devices.

Need to ensure that medication forms are present for all medications oral and/or topical. For prescription medications ensure that forms are done yearly and signed by parent/guardian and doctor. Medications need to be inaccessible to children and reflective of first and last names. (diaper ointments, oral meds, other creams, sunscreen). Old medications return to the parent/guardian. Diaper wipes cannot be accessible to children. 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.

Need to ensure that medication forms are present for all medications oral and/or topical. For prescription medications ensure that forms are done yearly and signed by parent/guardian and doctor. Medications need to be inaccessible to children and reflective of first and last names. (diaper ointments, oral meds, other creams, sunscreen). Old medications return to the parent/guardian. Diaper wipes cannot be accessible to children. 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.

Need to ensure that medication forms are present for all medications oral and/or topical. For prescription medications ensure that forms are done yearly and signed by parent/guardian and doctor. Medications need to be inaccessible to children and reflective of first and last names. (diaper ointments, oral meds, other creams, sunscreen). Old medications return to the parent/guardian. Diaper wipes cannot be accessible to children. Risk WAC/RCW

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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;

Tricycle outside was observed to have a cracked basket with sharp edges. The outlet cover in the toddler room was observed to be cracked and have sharp edges. Chipping paint was observed on chairs, table, walls, half door and some shelving. The chipping paint was also observed on play equipment/items outside. Small item on the toddler playground possibly broken from equipment was found and poses a choking hazard for toddlers.

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