110-300-0221(4)(a) · The diaper disposal container must be: (a) Hands-free and covered with a lid to prevent cross contamination;

Diaper pail was observed to not be in the restroom and was outside. According to the provider she bags the diapers up individually. The hands-free diaper pail was observed in the backyard (inaccessible space to children). Risk WAC/RCW

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110-300-0221(4)(b) · The diaper disposal container must be: (b) Lined with a disposable plastic trash bag; and

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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.

Child was observed to have a food allergy and the Individual Health Care Plan-FARE from the doctor but the form did not have

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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.

There was no medication form observed for a child that has medication for a food allergy. The form also needs to have the log in the file as well. Form must be completely filled out and signed by the parent and the doctor for the medications (zyrtec and epi-pen). In the restroom top drawer there was toothpaste and facial cleanser/creams accessible to children. Risk WAC/RCW

Open Not marked corrected in the state record

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110-300-0165(3)(f) · An early learning provider must take measures intended to prevent other hazards to children in care in early learning program space including, but not limited to: (f) Falling objects. Large objects that pose a risk of falling or tipping must be securely anchored. Large objects include, but are not limited to, televisions, dressers, bookshelves, wall cabinets, sideboards or hutches, and wall units;

Cording in kitchen main space was observed to be loose for the lamp in the space. Cording in room for the Xfinity Box and cable was observed loose and not secure. The cording can form loops. A roll of plastic bags was oberved in the restroom drawer and accessible to children. Cubbies require securing. Kitchenettes and shelving units required securing in rooms. In bedroom with xfinity cable box and cable there was chipping paint observed around the closet door. Washer and Dryer is housed in a closet next to the restroom. The door was observed to be unlocked and the washer and dryer had not latch on it.

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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.

There was no medication form observed for a child that has medication for a food allergy. The form also needs to have the log in the file as well. Form must be completely filled out and signed by the parent and the doctor for the medications (zyrtec and epi-pen). In the restroom top drawer there was toothpaste and facial cleanser/creams accessible to children. Risk WAC/RCW

Open Not marked corrected in the state record

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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.

There was no medication form observed for a child that has medication for a food allergy. The form also needs to have the log in the file as well. Form must be completely filled out and signed by the parent and the doctor for the medications (zyrtec and epi-pen). In the restroom top drawer there was toothpaste and facial cleanser/creams accessible to children. Risk WAC/RCW

Open Not marked corrected in the state record

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110-300-0145(1) · An early learning provider must visually inspect outdoor program space and equipment daily to ensure outdoor areas and equipment are free of hazards.

Grass needs to be cut, weeds, sticker bushes/weeds by the gate (entry) and high grass throughout yard was observed on the playground. Little Tikes slide was observed turned over in the yard. Risk WAC/RCW

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110-300-0146(1)(a)(b) · Playground equipment and surfacing used by an early learning provider must comply with applicable CPSC guidelines, as now and hereafter amended including, but not limited to, installing, arranging, designing, constructing, and maintaining outdoor play equipment and surfacing. (a) Climbing play equipment must not be placed on or above concrete, asphalt, packed soil, lumber, or similar hard surfaces;(b) The ground under swings and play equipment must be covered by a shock absorbing material (grass alone is not an acceptable) such as: (i) Pea gravel at least nine inches deep; (ii) Playground wood chips at least nine inches deep; (iii) Shredded recycled rubber at least six inches deep; or (iv) Any material that has a certificate of compliance, label, or documentation stating it meets ASTM standards F1292.

Little Tikes Slide was oberved in the yard turned over and on grass. The yard does not have any other ground covering other than grass in the yard. Risk WAC/RCW

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110-300-0165(2)(c) · 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;

Cording in kitchen main space was observed to be loose for the lamp in the space.

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110-300-0165(2)(d) · An early learning provider must take steps to prevent hazards to children including, but not limited to: (d) Making inaccessible to children plastic bags and other suffocation hazards;

Cording in kitchen main space was observed to be loose for the lamp in the space. Cording in room for the Xfinity Box and cable was observed loose and not secure. The cording can form loops. A roll of plastic bags was oberved in the restroom drawer and accessible to children. Cubbies require securing. Kitchenettes and shelving units required securing in rooms. In bedroom with xfinity cable box and cable there was chipping paint observed around the closet door.

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110-300-0165(3)(g) · An early learning provider must take measures intended to prevent other hazards to children in care in early learning program space including, but not limited to: (g) Equipment in poor condition. Equipment in poor condition (loose parts, rusty parts, flaking paint, or other dangers) must be repaired, removed, or made inaccessible to children.

Cording in kitchen main space was observed to be loose for the lamp in the space. Cording in room for the Xfinity Box and cable was observed loose and not secure. The cording can form loops. A roll of plastic bags was oberved in the restroom drawer and accessible to children. Cubbies require securing. Kitchenettes and shelving units required securing in rooms. In bedroom with xfinity cable box and cable there was chipping paint observed around the closet door. Washer and Dryer is housed in a closet next to the restroom. The door was observed to be unlocked and the washer and dryer had not latch on it. Water in the restroom was checked at the beginning of the visit and was at 127.9 degrees for the right sink and 128.3 for the left sink. The sink on the right did not have any running cold water which was fixed by the providers husband. Provider's husband worked on water and turned the hot water down the licensor rechecked the water prior to leaving the home and it was at 124.2 right sink and 123.8 the left sink which was an hour and 8 minutes after the licensor had arrived for the visit.

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110-300-0165(4)(e) · To ensure a safe environment for children in care, an early learning provider must comply with the following requirements: (e) Safe water temperature. All water accessible to enrolled children must not be hotter than 120 degrees Fahrenheit.

Cording in kitchen main space was observed to be loose for the lamp in the space. Cording in room for the Xfinity Box and cable was observed loose and not secure. The cording can form loops. A roll of plastic bags was oberved in the restroom drawer and accessible to children. Cubbies require securing. Kitchenettes and shelving units required securing in rooms. In bedroom with xfinity cable box and cable there was chipping paint observed around the closet door. Washer and Dryer is housed in a closet next to the restroom. The door was observed to be unlocked and the washer and dryer had not latch on it. Water in the restroom was checked at the beginning of the visit and was at 127.9 degrees for the right sink and 128.3 for the left sink. The sink on the right did not have any running cold water which was fixed by the providers husband. Provider's husband worked on water and turned the hot water down the licensor rechecked the water prior to leaving the home and it was at 124.2 right sink and 123.8 the left sink which was an hour and 8 minutes after the licensor had arrived for the visit. The outlet in the restroom was observed not be GFCI. Licensor discussed with provider if they are not using the outlet then to cover it with a blank faceplate. But if they are going to use it then ensure it is changed out to be GFCI and Tamper Resistant. Risk WAC/RCW

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110-300-0165(5)(b) · To ensure a safe environment for children in care, an early learning provider must comply with the following electrical requirements: (b) Outlets near sinks, tubs, toilets, or other water sources must be inaccessible to children or be tamper-resistant and equipped with a ground fault circuit interrupter (GFCI) outlet type;

Cording in kitchen main space was observed to be loose for the lamp in the space. Cording in room for the Xfinity Box and cable was observed loose and not secure. The cording can form loops. A roll of plastic bags was oberved in the restroom drawer and accessible to children. Cubbies require securing. Kitchenettes and shelving units required securing in rooms. In bedroom with xfinity cable box and cable there was chipping paint observed around the closet door. Washer and Dryer is housed in a closet next to the restroom. The door was observed to be unlocked and the washer and dryer had not latch on it. Water in the restroom was checked at the beginning of the visit and was at 127.9 degrees for the right sink and 128.3 for the left sink. The sink on the right did not have any running cold water which was fixed by the providers husband. Provider's husband worked on water and turned the hot water down the licensor rechecked the water prior to leaving the home and it was at 124.2 right sink and 123.8 the left sink which was an hour and 8 minutes after the licensor had arrived for the visit. The outlet in the restroom was observed not be GFCI. Licensor discussed with provider if they are not using the outlet then to cover it with a blank faceplate. But if they are going to use it then ensure it is changed out to be GFCI and Tamper Resistant. Risk WAC/RCW

Open Not marked corrected in the state record

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110-300-0230(3) · (3) A first-aid kit must include: (a) Disposable nonporous protective nonlatex gloves; (b) Adhesive bandages of various sizes; (c) Small scissors; (d) Tweezers; (e) An elastic wrapping bandage; (f) Sterile gauze pads; (g) Ice packs; (h) A disposable or mercury free thermometer that uses disposable sleeves, or is cleaned and sanitized after each use; (i) A sling, or a large triangular bandage; (j) Adhesive tape; (k) A CPR barrier with a one-way valve or both an adult and pediatric CPR mask with a one-way valve; (l) A current first-aid manual; and (m) Hand sanitizer (for adult use only).

First Aid kit was missing Ace Bandage. 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.

Licensor reviewed MERIT prior to going to the visit and noted the missing training for assistant, Z.M and the provider, H.M. The licensor informed the provider, H.M during the visit that her assistant was missing Safe Sleep Training that it expired 6/13/2024. The licensor also informed her to just let her know that she needed to complete it even though she currently is not and has not been working at the program. Licensor requested that provider create a file for her assistant even if she has not started working yet so the information could be verified in the MERIT system (CPR/First Aid, Food Handlers) Licensor also informed her that Z.M's BBP was expired as well according to MERIT. Licensor informed the provider she was missing: Safe Sleep expired 6/6/2024; BBP expired 6/4/2024; Food Handlers expired 6/6/2024and thea she would need to get these items done. Licensor informed provider that she would provide her with the link for BBP. https://wisha-training.lni.wa.gov/Training/articulate/BBPathogens/story.html Risk WAC/RCW

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110-300-0460(4)(a) · A health record must include: (a) An immunization record, pursuant to WAC 110-300-0210(1);

Children files were observed to be missing: Start dates, Agreement forms, health history, Individual Care Form for Food Allergy and Special Needs, Immunization record, address missing from medical consent, dettnal exam date, dental phone number and/or address, authorized pick up person. Risk WAC/RCW

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110-300-0460(4)(e) · A health record must include: (e) Medical and dental care provider names and contact information or what facility parents or guardians would prefer for treatment;

Children files were observed to be missing: Start dates, Agreement forms, health history, Individual Care Form for Food Allergy and Special Needs, Immunization record, address missing from medical consent, dettnal exam date, dental phone number and/or address, authorized pick up person. Risk WAC/RCW

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110-300-0460(4)(f) · A health record must include: (f) Dates of the child's last physical and dental exams, if available;

Children files were observed to be missing: Start dates, Agreement forms, health history, Individual Care Form for Food Allergy and Special Needs, Immunization record, address missing from medical consent, dettnal exam date, dental phone number and/or address, authorized pick up person. Risk WAC/RCW

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110-300-0505(1)(2) · (1) Postings listed in subsection (2) of this section that are part of an early learning program must be clearly visible to parents, guardians, and early learning program staff. (2) Postings on early learning premises must include: (a) The child care license, pursuant to WAC 110-300-0010; (b) Floor plan with emergency routes and exits identified in each child care area, pursuant to WAC 110-300-0400(1)(b)(i) and 110-300-0470(2)(a)(i); (c) Dietary restrictions, known allergies, and nutrition requirements, if applicable, in a location easily accessible for staff but not available to those who are not parents or guardians of the enrolled child, pursuant to 110-300-0186(8); (d)Handwashing practices at each handwashing sink, pursuant to WAC 110-300-0200(1); (e) If applicable, diaper changing or stand-up diapering procedure at each diapering station, pursuant to WAC 110-300-0220 and 110-300-0221(1)(d); (f) Pesticide treatment, if applicable, pursuant to RCW 43.216.280 and 17.21.410(1)(d); (g) Emergency numbers and information, including but not limited to: (i) 911 or emergency services number; (ii) Name, address and directions from the nearest arterial street or nearest cross street to the facility; (iii) The department’s toll-free number; (iv) Washington poison center toll-free number; and (v) The department’s child protective services; (h) The location of emergency medical information for children and staff; (i) A notice of any current or pending enforcement action, including probationary licenses pursuant to RCW 43.216.687. Notice must be posted: (i) Immediately upon receipt; and (ii) For at least two weeks or until the violation causing the enforcement action is corrected, whichever is longer. (j) A notice of safe sleep violation in the licensed space as required by WAC 110-300-0291(2), if applicable; (k) “No smoking” and “No vaping” signs, pursuant to WAC 110-300-0420(2)(f); (l) A copy of a department approved waiver or variance from a rule of this chapter, if applicable. Waivers or variances must be posted for parent or guardian view when related to the overall program (not related to any specific child), and as long as the waiver or variance is approved; (m) Insurance coverage, or a lapse or termination of such coverage if applicable, pursuant to RCW 43.216.700; and (n) Any other information listed in RCW 43.216.687.

Floor plans were not observed posted in all licensed spaces. Wording regarding where emergency information for staff was not posted. There was no daily scheduele posted. Risk WAC/RCW

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110-300-0240(2) · Hard surfaces in early learning programs including, but not limited to, floors (excluding carpet), walls, counters, bookshelves, and tables must be smooth and easily cleanable.

Kitchen floor observed to be peeling and there is unsealed flooring in areas./uncleanable surface. Risk WAC/RCW

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(a) A cleanable surface must be: (i) Designed to be cleaned frequently and made of sealed wood, linoleum, tile, plastic, or other solid surface materials; (ii) Moisture resistant; and (iii) Free of chips, cracks, and tears.

Kitchen floor observed to be peeling and there is unsealed flooring in areas./uncleanable surface.

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