Lil Explorers School of Boerne

Immunization Records, Exceptions, and Exemptions Current

“2 out of 10 child files evaluated were missing updated immunization records.”

Rule 746.613(b). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Oct 20, 2023. Correction verified: Oct 11, 2023.

Garbage Inaccessible to Children; Maintained in Sanitary Manner

“The trash can in the Dogwood room did not have a cover preventing children from accessing the debris inside.”

Rule 746.3407(8). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 19, 2023. Correction verified: May 4, 2023.

Safety - Areas Free From Hazards

“There was 1 loose outlet allowing children to potentially access the electrical outlet box in the wall and there were 2 outlet boxes exposed without covers in the Lavender room. A sink in the restroom between Hawthorn and Sassafras rooms was pulling away from the wall.”

Rule 746.3701. Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 20, 2023. Correction verified: May 4, 2023.

Animals at Center - Documentation of Vaccinations

“2 out of 3 cats at the operation did not have a copy of their rabies vaccination on file. Note: The vaccination records were obtained during the inspection.”

Rule 746.3903(a). Medium High, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Apr 19, 2023.

Written Feeding Instructions - Review and Update Every 30 Days

“4 out of 9 infant feeding instructions were not current in the Orange Blossom room. 5 out of 9 feeding instructions were not current in the Peach Blossom room. Feeding instructions were last updated in January and February.”

Rule 746.2421(b). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 21, 2023. Correction verified: Apr 24, 2023.

Animals at Center - Statement of Health from Veterinarian

“1 out of 3 cats at the operation did not have a health statement on file. Note: The health statement was obtained from the veterinarian during the inspection.”

Rule 746.3903(b). Medium, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Apr 19, 2023.

Immunization Records, Exceptions, and Exemptions Current

“2 out of 10 child files reviewed needed updated immunization records. One child (9 mos) was missing their 3rd DTaP and 3rd PCV vaccine. One child (7 mos) was missing their 2nd Hep B vaccination.”

Rule 746.613(b). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Oct 28, 2022. Correction verified: Nov 2, 2022.

Health Statement on File within 1 Week of Admission

“1 out of 10 child files reviewed was missing a health statement.”

Rule 746.611(b). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Oct 28, 2022. Correction verified: Nov 1, 2022.

Required Personnel Records- Training Hours

“4 out of 10 staff files evaluated were missing annual training hours. One caregiver completed 12/24 hours of training, one caregiver completed 18/24 hours of training, one caregiver completed 6/24 hours of training and the director did not have any training certificates available to evaluate.”

Rule 746.901(5). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Nov 4, 2022. Correction verified: Nov 15, 2022.

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

“The operation used poor judgment in allowing an 8 year old child in the kitchen.”

Rule 746.1201(1). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 6, 2022. Correction verified: Jul 20, 2022.

Responsibilities of Caregivers - Supervision of Children

“A child, age 8 years, was observed in the kitchen playing on an electronic device alone without direct supervision. The child was on the floor of the kitchen behind a metal shelf. The closest caregiver was in the front office. There was a curtain that was closed separating the kitchen and office area and preventing a caregiver from being able to see the child.”

Rule 746.1203(4). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 6, 2022. Correction verified: Jul 20, 2022.

Floors, ceilings and Walls in Good Repair and Clean

“A piece of drywall has been cut, resulting in exposing electrical wires that lead from a breaker box located in the Magnolia Room restroom. NOTE: This is a recite from investigation #2883999”

Rule 746.3407(9). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 15, 2022. Correction verified: Jul 20, 2022.

AP Background ck determination - If provisionally eligible w/conditions or eligible w/conditions you must restrict duties per conditions/restrictions

“A caregiver that has a provisional background check had direct access to 4 children ages 6-12 months of age. NOTE: The caregiver was moved to another classroom with a caregiver that had an eligible clearance.”

Rule 745.635(3). High, by Texas’s label. Correction date, as Texas HHSC recorded it: May 3, 2022. Correction verified: May 17, 2022.

Safety - Areas Free From Hazards

“This is a recite: One classroom bathroom contained cleaning solution and wet floor mop pads within reach of the children 2 years of age.”

Rule 746.3701. Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 5, 2022. Correction verified: Apr 29, 2022.

Installation and Maintenance of Loose-fill Surfacing - Proper Depth Maintained

“This is a recite: The playground with the tire climber and slides had soft surface measurements of 1/2 inch - 1 inch at the end of the slides and measurements of 2-5 inches under the climbing unit. The 3-4 year old playground measured soft surface areas under the rocking climbers between 3- 5 inches in 3 areas measured.”

Rule 746.4907(d). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 15, 2022. Correction verified: Apr 29, 2022.

Written Feeding Instructions - Signed and Dated by Parent or Health-Care Professional

“This is a recite: 2 children had feeding schedules but were not signed by parents. 1 child’s feeding schedule was last updated in Feb 2022.”

Rule 746.2421(a). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 7, 2022. Correction verified: Apr 29, 2022.

No Swaddling of Infant Unless Completed Sleep Exception Form on File

“One infant in the 3-6 mos room was found in their crib in a sleep sack that restricted the child’s arms. A second child was found in their crib swaddled.”

Rule 746.2428. High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 22, 2022. Correction verified: Apr 5, 2022.

Safety Requirements for Active Play Equipment - Securely Anchored

“Two arch climbers were found on the preschool playground not attached to the ground and could be moved or lifted.”

Rule 746.4601(5). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 25, 2022. Correction verified: Apr 5, 2022.

Safety - Areas Free From Hazards

“Two classrooms were found to have cleaning chemicals and sun tan lotion accessible to children in the restroom.”

Rule 746.3701. Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 22, 2022. Correction verified: Apr 5, 2022.

Installation and Maintenance of Loose-fill Surfacing - Proper Depth Maintained

“The preschool playground had less than 6 inches of fall zone surfacing under the climbing tires, stationary rocking climbers and arch climbers.”

Rule 746.4907(d). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 1, 2022. Correction verified: Apr 5, 2022.

Mounting of Fire Extinguishers

“A fire extinguisher was found in a 3 year old classroom that was not mounted and placed over 5 feet off the floor on top of a cubby.”

Rule 746.5305. Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 23, 2022. Correction verified: Apr 5, 2022.

Electronic or Battery-Operated Carbon Monoxide Detector-Document Test Date, Battery Installation Date, and Staff Name Testing and Installation

“The operation had not recorded monthly carbon monoxide detector testing for January and February. NOTE: The assistant director was able to reference past calendar dates and enter the dates the units were tested during the inspection.”

Rule 746.5537(a)(3). Medium High, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Mar 22, 2022.

Written Feeding Instructions - Signed and Dated by Parent or Health-Care Professional

“6 out of 8 infants int he 3-6 mon classroom did not have a feeding schedule on file.”

Rule 746.2421(a). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 25, 2022. Correction verified: Apr 5, 2022.

Documentation of Drills

“The operation had not recorded monthly fire drills conducted for January or February. NOTE: The assistant director was able to update the emergency log using calendar dates of when the drills were conducted during the inspection.”

Rule 746.5205(4). Medium, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Mar 22, 2022.