Joyous Montessori Keller

Provide care consistent with child’s habits, interests, strengths, special needs, including any special supervision needs

“A child was injured while in care and the caregivers have no knowledge of how it happened. They did not see the incident.”

Rule 746.1203(4). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Oct 20, 2023. Correction verified: Oct 30, 2023.

Parental Notification of Less Serious Injuries

“An injury that a child received while in care, was not reported to parents accurately.”

Rule 746.307(c). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Oct 20, 2023. Correction verified: Oct 30, 2023.

Safety Requirements for Active Play Equipment - No Entanglement Protrusions or Openings

“I observed playground equipment that presents strangulation risk as there are string hanging down from the structure. Photos were taken.”

Rule 746.4601(4). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jun 26, 2023. Correction verified: Jun 28, 2023.

Each Caregiver and the Director Must Have Current Training in pediatric first aid with rescue breathing and choking.

“1 caregiver does not have current first aid training,”

Rule 746.1315(a). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Feb 10, 2023. Correction verified: Feb 10, 2023.

Each Caregiver and the Director Must Have Current Training in pediatric CPR

“1 caregiver does not have current CPR training,”

Rule 746.1315(b). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Feb 10, 2023. Correction verified: Feb 9, 2023.

Child/ Caregiver Ratio - 13 or More Children

“The 3 year old classroom was observed out of ratio with 17 children and 1 teacher.”

Rule 746.1601. Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Feb 9, 2023. Correction verified: Feb 21, 2023.

Responsibilities of Caregivers - Know Group Responsible For

“2 caregivers were unaware of how many children they were responsible for. They stated that they had 18 children, when there was 19 children in the classroom.”

Rule 746.1203(2). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Dec 7, 2022. Correction verified: Dec 14, 2022.

Diapering Procedures-Soiled clothes sent home

“There is soiled pants accessible to other children in the bathroom of the 2 year old classroom. The pants were not sealed in a plastic bag.”

Rule 746.3505(g). Medium High, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Dec 7, 2022.

Required Admission Information - Special Needs Statement

“There is one child with a diagnosed food allergy that does not have medication present. Mom brought the epi pen to the operation to keep.”

Rule 746.605(13). Medium High, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Nov 30, 2022.

Responsibilities of Caregivers - Supervision of Children

“Children were observed playing in the restroom unsupervised for 15 minutes. The children could be seen playing with items in the bathroom and sticking their hands down into the toilet multiple times.”

Rule 746.1203(4). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Nov 4, 2022. Correction verified: Nov 8, 2022.

Director Responsibilities - Employee Assignments

“A caregiver did not have the skills or abilities needed to care for children in the 2?3-year-old classroom. This resulted in using excessive force during nap time.”

Rule 746.1003(3). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Dec 1, 2022. Correction verified: Dec 7, 2022.

Prohibited Punishments - No Harsh, Cruel or Unusual

“A caregiver was observed using excessive force when handling 3 children at naptime.”

Rule 746.2805. High, by Texas’s label. Correction date, as Texas HHSC recorded it: Dec 1, 2022. Correction verified: Dec 7, 2022.

Prohibited Punishments - Hitting with Hand or Instrument

“A caregiver was observed hitting a child in the head with an open hand.”

Rule 746.2805(4). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Dec 1, 2022. Correction verified: Dec 7, 2022.

Discipline - Positive Methods of Discipline and Guidance

“A caregiver grabbed a child by the arm in a harsh manner as a means of discipline and guidance.”

Rule 746.2803(4). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Nov 4, 2022. Correction verified: Nov 8, 2022.

Responsibilities of Employees and Caregivers -Demonstrate Competency, Good Judgment, Self-control

“One caregiver offered a child’s left over lunch when they were done to another child. The food offered was on the plate and had been touched by the child who did not want to finish the food.”

Rule 746.1201(1). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Sep 28, 2022. Correction verified: Oct 11, 2022.

Responsibilities of Caregivers - Know Children’s Names and Ages

“One caregiver was unsure of the children’s ages that she was responsible for. The list of birthdays was not complete so she was not able to confirm the ages without doubt.”

Rule 746.1203(3). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Sep 28, 2022. Correction verified: Oct 11, 2022.

Each Caregiver and the Director Must Have Current Training in pediatric first aid with rescue breathing and choking.

“1 of 10 caregivers did not have current first aid training available for review at the time of the inspection.”

Rule 746.1315(a). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Sep 29, 2022. Correction verified: Sep 30, 2022.

Each Caregiver and the Director Must Have Current Training in pediatric CPR

“1 of 10 caregivers did not have current CPR training available for review at the time of the inspection.”

Rule 746.1315(b). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Sep 29, 2022. Correction verified: Sep 30, 2022.

Maintenance of Building, Grounds and Equipment

“On the playground, there was animal feces, missing loose fill where water has washed it out, and a considerable amount of stickers in the grassy area of the outdoor space. Meagan used a shovel to remove the animal feces and even out the mulch where it was missing.”

Rule 746.3407. Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Sep 28, 2022. Correction verified: Oct 11, 2022.

Fire Drill Monthly - Exit in 3 Minutes

“There was no fire drill conducted in August.”

Rule 746.5205(1). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Sep 30, 2022. Correction verified: Oct 11, 2022.

Meal and Snack Service - Allow Children to Feed Themselves

“The 4-6 year old children were not given utensils for lunch and they were eating with their hands. Meagan gave all of the children utensils when she entered the classroom at the end of the meal.”

Rule 746.3319(a)(2). Medium, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Sep 28, 2022.

Medication No Longer Used

“There is a bottle for children’s motrin that is stored in the office for a child that is no longer enrolled. The medication was thrown away immediately/”

Rule 746.3809. Medium, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Sep 28, 2022.

Annual Sanitation Inspection

“The sanitation inspection was due February of 2022.”

Rule 746.3401(a). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 18, 2022. Correction verified: Jul 28, 2022.

Required Admission Information - Special Needs Statement

“1 of 4 children’s files I reviewed was missing a special needs statement.”

Rule 746.605(13). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 21, 2022. Correction verified: Jul 21, 2022.

Required Admission Information-Completed Food Allergy Plan

“One child that is allergic to eggs does not have an emergency allergy plan at the operation.”

Rule 746.605(16). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 21, 2022. Correction verified: Jul 26, 2022.

Required Admission Information - Emergency Contact

“4 of the 4 children’s records that I reviewed was missing an address for the emergency contact.”

Rule 746.605(6). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 21, 2022. Correction verified: Jul 21, 2022.

Report Outbreak of Communicable Illness

“Licensing was notified 3-5 days after the operation was notified about 5 different COVID cases.”

Rule 746.305(a)(4). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 11, 2022. Correction verified: Jul 26, 2022.

Director Responsibilities - Operate in Compliance

“The director is not ensuring the employees are operating in compliance of the minimum standards.”

Rule 746.1003(1). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 5, 2022. Correction verified: Jul 18, 2022.

Activities for Infants - Not in Restrictive Device for more than 15 Minutes

“There was 4 infants that were observed sitting in an infant feeding activity table for approximately 45 minutes.”

Rule 746.2417(2)(B). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 5, 2022. Correction verified: Jul 18, 2022.

Infant May Not Sleep in a Restrictive Device

“An infant was observed sleeping in a restctive equipment.”

Rule 746.2426. High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 5, 2022. Correction verified: Jul 18, 2022.

Storage of Medication - Inaccessible to Children

“I observed diaper cream that specified ‘keep out of reach of children’ on a low shelf that children has access to.”

Rule 746.3807(1). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 5, 2022. Correction verified: Jul 18, 2022.

Responsibilities of Caregivers - Know Children’s Names and Ages

“A caregiver did not know the ages of the children she was responsible for nor did she have access to their birth dates.”

Rule 746.1203(3). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 5, 2022. Correction verified: Jul 18, 2022.

Child/ Caregiver Ratio - 13 or More Children

“When I arrived, I observed 13 children (SAG: 2yrs) with one caregiver in one todder classroom and 16 children (SAG: 3 yrs) with one caregiver in another toddler classroom.”

Rule 746.1601. Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 5, 2022. Correction verified: Jul 18, 2022.

Annual Sanitation Inspection

“The sanitation inspection was due February of 2022.”

Rule 746.3401(a). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 5, 2022. Correction verified: Jul 18, 2022.

Children Handwashing After Toileting or Diapering

“There was a child who did not wash her hands after using the restroom.”

Rule 746.3417(3). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 5, 2022. Correction verified: Jul 18, 2022.

Hand Sanitizer - Stored Out of Child’s Reach When Not in Use

“Hand sanitizer was observed within reach of children when not in use in the two older classrooms.”

Rule 746.3420(5). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 5, 2022. Correction verified: Jul 18, 2022.

Medication Authorization - Signed and Dated

“There was medication brought by the parent but did not fill out authorization for administering medication.”

Rule 746.3803(a)(1). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 5, 2022. Correction verified: Jul 18, 2022.

Administering Medication - Original Container with Child’s Name, Date

“Medication at the operation did not have the date the medication was brought to the operation or the full name of the child labeled on the packaging.”

Rule 746.3805(b)(1). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 5, 2022. Correction verified: Jul 18, 2022.

Food Allergy Emergency Plan Signed by Parents and Health Care Professional

“1 of the 10 childrens files that I reviewed indicated a diagnosed food allergy but was missing an emergency allergy plan.”

Rule 746.3819. Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 8, 2022. Correction verified: Jul 8, 2022.

Fire Drill Monthly - Exit in 3 Minutes

“Although the center is practicing the emergency drills, they are not exiting the building in the required time. January, March, April, and June is documented with an exit time of 4 minutes and more.”

Rule 746.5205(1). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 19, 2022. Correction verified: Jul 18, 2022.

Required Admission Information - Special Needs Statement

“1 of the 10 childrens records I reviewed was missing a special needs statement.”

Rule 746.605(13). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 8, 2022. Correction verified: Jul 18, 2022.

Required Admission Information - Emergency Contact

“4 of the 10 childrens records that I reviewed was missing an address for the emergency contact.”

Rule 746.605(6). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 8, 2022. Correction verified: Jul 18, 2022.

Sign-in and Sign-out Tracking System

“The caregivers have access to a tracking system, however there was no unique identifier for who signed the children in and there way only 8 of 16 present children signed in.”

Rule 746.631(a). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 5, 2022. Correction verified: Jul 18, 2022.

Written Activity Plan - Outline Daily Activities

“There was no activity plan that specified the daily activities for the current date. The June activity plan was the same for all ages and is not specific to the age groups.”

Rule 746.2205(a)(2). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 8, 2022. Correction verified: Jul 18, 2022.

Activities for Infants - Outdoor Play Daily

“The infant caregiver mentioned that they are not taking the infants outside on a daily basis.”

Rule 746.2417(1). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 5, 2022. Correction verified: Jul 18, 2022.

Children Not Required to Sleep - May Not Force Child to Sleep

“During naptime, I observed 7 children with blankets on their head.”

Rule 746.2905(1). Medium, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Jul 5, 2022.

Medication Authorization - Parent May Not Authorize in Excess of Label Directions or Child’s Health-Care Professional Directions

“A parent instructed the operation to administer 6mL of a medication, but the instructions state “do not use unless instructed by a doctor” for the age of the child.”

Rule 746.3803(c). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 5, 2022. Correction verified: Jul 18, 2022.

Medication No Longer Used

“There is medication present for a child that has recently disenrolled.”

Rule 746.3809. Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 5, 2022. Correction verified: Jul 18, 2022.

Children’s Records - Health Statement

“1 of 10 childrens records reviewed is missing a health care statement.”

Rule 746.603(a)(3). Medium, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Jul 5, 2022.