Cradles and Crayons

Child/Caregiver Ratio - 18 Months Difference in Age

“Fifteen children were placed in one area doing the same activity with the youngest child being 9 months and the oldest being 10 years old.”

Rule 746.1605(1). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jun 16, 2023. Correction verified: Jul 5, 2023.

Requirements for Feeding Infants - Other Use of Handwashing Sink

“Three bottles were washed at the hand washing sink in the infant room.”

Rule 746.2419(8). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jun 16, 2023. Correction verified: Jul 5, 2023.

Food Service and Preparation Requirement - Cover All Stored Food

“Food in refrigerator was stored uncovered.”

Rule 746.3317(8). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jun 16, 2023. Correction verified: Jul 5, 2023.

Employee Handwashing After Diapering a Child

“The infant caregiver did not wash her hands between diaper changes of two infants.”

Rule 746.3415(4). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jun 16, 2023. Correction verified: Jul 5, 2023.

Screen Time Activities - Not Used for Under Two

“Three infants were observed watching a movie with school aged children in the same room.”

Rule 746.2207(a). Medium, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Jun 16, 2023.

Mark Cleaning Supplies, Toxic Materials; Keep Separate from Food and Inaccessible to Children

“Cleaning supplies were accessible to children in care in the main classroom. Multi-purpose spray cleaner was placed on 3ft shelf.”

Rule 746.3407(12). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jun 16, 2023. Correction verified: Jul 5, 2023.

Food Service and Preparation Requirement - Safe and Sanitary

“Food stored in refrigerator was observed to be passed the expiration date.”

Rule 746.3317. Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jun 16, 2023. Correction verified: Jul 5, 2023.

AP Cribs - Only Snug Fitting Sheet and Crib Mattress Cover Allowed if Infant Younger than 12 Months of Age

“A ten-month-old infant was observed sleeping on bouncy with a blanket inside a crib. Corrected during inspection infant caregiver removed the blanket and bouncy from the crib. Infant did not have a medical need to sleep in a bouncy inside the crib. Photos were taken.”

Rule 746.2415(b). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 10, 2023. Correction verified: Mar 16, 2023.

Infant May Not Sleep in a Restrictive Device

“Inspector observed a thirteen-month-old and a fifteen-month-old infant sleeping in stationary swings at 11:58am. Infant caregiver confirmed, infants fell asleep approximately around 10:59am. Infants did not have a medical need for sleeping in the swings. Corrected during the inspection, both infants were placed in their individual cribs. Photos were taken.”

Rule 746.2426(a)(1). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 10, 2023. Correction verified: Mar 16, 2023.

Sign-in and Sign-out Tracking System

“Sign-in log was not available for parents to sign-in children during early morning drop off at the center.”

Rule 746.631(a). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 6, 2023. Correction verified: Mar 9, 2023.

Written Feeding Instructions - Review and Update Every 30 Days

“Infant monthly feeding instructions had not been updated since infant’s enrollment November 2022.”

Rule 746.2421(b). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 6, 2023. Correction verified: Mar 9, 2023.

Required Admission Information - Emergency Medical Authorization

“One child’s file was missing authorization signature for emergency medical care.”

Rule 746.605(12). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Oct 18, 2022. Correction verified: Oct 11, 2022.

Pre-service Training for Caregivers of Children Under 24 Months

“Two caregivers who take care of children under 24 months were missing SIDS and Shaken Baby Syndrome training.”

Rule 746.1305(b). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Oct 18, 2022. Correction verified: Oct 11, 2022.

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

“One caregiver in care of children did not have pediatric first aid training.”

Rule 746.1315(a). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Oct 18, 2022. Correction verified: Oct 11, 2022.

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

“One caregiver in care of Children did not have pediatric CPR training.”

Rule 746.1315(b). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Oct 18, 2022. Correction verified: Oct 11, 2022.

Cots, Beds, Mats Labeled With Child’s Name

“Four 12-month-old infants’ cots were not labeled.”

Rule 746.4503(b). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Oct 18, 2022. Correction verified: Oct 20, 2022.

Required Admission Information - Physician Information

“One child’s file was missing a medical health statement.”

Rule 746.605(11). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Oct 18, 2022. Correction verified: Oct 11, 2022.

Required Records Maintained and Made Available - Personnel and Training Records

“One of operation’s director’s file was not available during the inspection.”

Rule 746.801(3). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Oct 18, 2022. Correction verified: Oct 20, 2022.