Children’s Center of Excellence and Daycare

Caregiver Qualification Age Exemption Attends High School - Supervised By Qualified Caregiver

“A 17 yr old caregiver who currently attends high school was observed to be left unsupervised with a group of children multiple times. The supervising caregiver was observed to be going back and forth between the kitchen and classroom.”

Rule 746.1109(b)(2). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Oct 31, 2023. Correction verified: Dec 21, 2023.

Training Requirements for Employees, Caregivers, and Directors - Pre-Service Training

“Records were reviewed for 10 staff. 2 caregiver with less than 2 years of child care experience hired June and July 2023, did not have the required 24 hours of training within 90 days of employment. 1 caregiver with no previous experience had documentation of training. NOTE: Caregivers hired June and July of 2023 had 8 hours of pre-service training documented.”

Rule 746.1301(a)(2)(A). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Nov 17, 2023. Correction verified: Dec 21, 2023.

Required Records Maintained and Made Available - Personnel and Training Records

“Records for 10 staff including the director was reviewed. All records were observed to be missing the following: Date of hire Documentation whether pre-service training be required. Documentation all required orientation topics have been received.”

Rule 746.801(3). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Nov 10, 2023. Correction verified: Jan 5, 2024.

Prohibited Punishments - Using Inappropriate Long Period of Silence or Inactivity Including Requiring Child to Remain in a Restrictive Device

“A caregiver placed a child in a high chair for misbehaving during the inspection.”

Rule 746.2805(10). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Aug 25, 2023. Correction verified: Aug 30, 2023.

Chairs - Safety Straps Used if Required by Manufacturer

“Children were observed sitting in high chairs and the safety straps were not secured. Note: The provider secured the straps for each child during the inspection.”

Rule 746.4501(b). Medium, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Aug 25, 2023.

Smoke Detectors Testing

“Documentation showing the smoke detectors have been tested monthly was not available for review upon request.”

Rule 746.5319. High, by Texas’s label. Correction date, as Texas HHSC recorded it: Aug 4, 2023. Correction verified: Aug 1, 2023.

Electronic or Battery-Operated Carbon Monoxide Detector-Check All Detectors Monthly

“Documentation showing the carbon monoxide detectors are being tested monthly was not available for review upon request.”

Rule 746.5537(a)(2). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Aug 4, 2023. Correction verified: Aug 1, 2023.

Medication No Longer Used

“During the inspection expired boxes of Benadryl and Neosporin ointment was observed and has not been disposed of. Note: The provider disposed the medication during the inspection.”

Rule 746.3809. Medium, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Jul 27, 2023.

Chairs - Safety Straps Used if Required by Manufacturer

“Children were observed sitting in chairs equipped with safety straps and the safety straps were not secured. Note: The provider secured the straps for each child during the inspection.”

Rule 746.4501(b). Medium, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Jul 27, 2023.

Children’s Records - Immunizations

“1 out of 4 chidlren’s files evaluated did not contain documentation of current immunizations. The record provided was missing 1 dose of MMR and 1 dose of VAR.”

Rule 746.603(a)(4). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Aug 4, 2023. Correction verified: Aug 2, 2023.

Policies Comply with Rules

Rule 746.201(1). High, by Texas’s label. Correction date, as Texas HHSC recorded it: May 30, 2023. Correction verified: May 30, 2023.

Training Requirements for Employees, Caregivers, and Directors - Pediatric CPR

“1 out of 8 employee files evaluated did not contain current CPR/First Aid training. The certifiate provided had expired on May 4th, 2023.”

Rule 746.1301(a)(4)(A). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: May 23, 2023. Correction verified: May 23, 2023.

Children’s Records Maintained

“Children’s files evaluated did not contain a complete record. The following information was missing or incomplete: - Two were missing the address, and phone # of the emergency medical facility - Three were missing the special needs statements - Two were missing the parents signature for receiving a copy of the operational policies”

Rule 746.603(a). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: May 30, 2023. Correction verified: May 30, 2023.

Required Personnel Records

“7 out of 8 staff files evaluated did not contain a complete personnel record. The following information was missing: 4 were missing the Licensing affidavits were not notarized 2 were missing the Proof of education was missing 3 were missing Signatures that the staff have completed orientation to the center”

Rule 746.901. Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: May 30, 2023. Correction verified: May 30, 2023.

Documentation of Training Requirements - Original Training Certification Card or Letter in each Employee’s personnel record

“Documentation showing training in the following topics were not available for review during the inspection: - Recognizing and Reporting Suspected Abuse and Neglect of Children - Transportation Safety Training”

Rule 746.1329(a). Medium Low, by Texas’s label. Correction date, as Texas HHSC recorded it: May 30, 2023. Correction verified: May 30, 2023.

Report Outbreak of Communicable Illness

“The operation did not report an outbreak of hand, foot, and mouth to childcare regulation.”

Rule 746.305(a)(4). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jun 22, 2023. Correction verified: Jul 3, 2023.

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

“A caregiver with a conditonal background check stating they must never be left alone with child was left alone with 6 infant 4-15mo”

Rule 745.635(3). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 30, 2023. Correction verified: Apr 13, 2023.

Child/ Caregiver Ratio - 13 or More Children

Rule 746.1601. Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 30, 2023. Correction verified: Apr 13, 2023.

Responsibilities of Caregivers - Know children responsible for

“2 caregivers in the infant room were not aware of the number of children in their care. When asked, both caregivers stated there were 5 children in care. When asked again, they again stated there were 5. The caregivers were informed CCR counted 6 children. One careigver then stated they forgot a child was just brought into the classroom”

Rule 746.1205(a)(1). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 16, 2023. Correction verified: Mar 30, 2023.

Required Equipment in Vehicles - Emergency Medical Information

“The vehicle used for transportation did not have emergency medical authorization for any of the children being transported.”

Rule 746.5617(a)(2). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 16, 2023. Correction verified: Mar 30, 2023.

Required Equipment in Vehicles - Fire Extinguisher

“The fire extinguisher was observed to be located in the trunk of the vehicle used for transportation and was not readily accessible by the driver.”

Rule 746.5617(a)(5). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 16, 2023. Correction verified: Mar 30, 2023.

First Aid Kit - Easily Accessible to Employees

“The first aid kit was observed to be located in the truck of the vehicle used for transportation and was not readily accessible by the driver.”

Rule 746.4001(3). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 16, 2023. Correction verified: Mar 30, 2023.

Sign-in and Sign-out Tracking System

“The operation does not keep a sign-in/out log for children being transported.”

Rule 746.631(a). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 16, 2023. Correction verified: Mar 30, 2023.

Written Feeding Instructions - Review and Update Every 30 Days

“One child not yet on table food did not have updated feeding instructions. Instructions were last reviewed and signed by the parent 2/1/23”

Rule 746.2421(b). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 20, 2023. Correction verified: Mar 30, 2023.

AP Report Child Injury Requiring Medical Treatment by a Health-Care Professional or Hospitalization

“Based on the information obtained during the DFPS investigation, the operation failed to report a child injury that required medical treatment.”

Rule 746.305(a)(2). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jan 19, 2023. Correction verified: Jan 24, 2023.

Safety - Areas Free From Hazards

“Based on the information obtained during the DFPS investigation, the operation failed to ensure the areas were free of all safety hazards. A bottle warmer was stored in a manner that did not ensure the cord was out of reach of the children, resulting in a child injury.”

Rule 746.3701. Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jan 19, 2023. Correction verified: Jan 24, 2023.

Responsibilities of Caregivers - Know Group Responsible For

“2 caregivers were not aware of the number of children in their care. When asked, both caregivers were asked multiple times how many children were in their care, and both stated there were 15. 16 children were counted in care.”

Rule 746.1203(2). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Nov 15, 2022. Correction verified: Dec 1, 2022.

Chairs - Safety Straps Used if Required by Manufacturer

“14 children were observed sitting in bucket seat style tables and the straps were not observed to be in use. Two of the seats did not have straps.”

Rule 746.4501(b). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Nov 22, 2022. Correction verified: Dec 1, 2022.

Additional Minimum Qualifications for Caregivers - HS Diploma, Equivalent, Certification of Completion

“One caregiver did not have documentation of a high school diploma or equivalent on file.”

Rule 746.1107(2). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 28, 2022. Correction verified: Aug 12, 2022.

Documented Annual Training - Caregivers of Children Under 24 Months Required

“Records were reviewed for 6 staff including the director, three caregivers did not have training in the following topics: Hazardous materials Building and physical premise safety Emergency preparedness Responding to food and allergic reaction”

Rule 746.1309(d). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 28, 2022. Correction verified: Aug 12, 2022.

Arrangement of Napping Equipment - Not Blocking Entrances or Exits

“In the toddler room, a child was observed to be sleeping on a cot that was placed in front of the emergency exit. The exit could not be accessed without stepping over the child”

Rule 746.2909(1). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 14, 2022. Correction verified: Jul 19, 2022.

Safety - Areas Free From Hazards

“During the walkthrough, in the infant, toddler, and school age rooms, staff purses were observed to be in reach of children NOTE: Corrected at inspection, all purses were moved to high hooks or shelved and were out of reach of children”

Rule 746.3701. Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 14, 2022. Correction verified: Jul 19, 2022.

Storage of Medication - Refrigerate Separate from Food

“Refrigerated medication was observed to be stored next to food.”

Rule 746.3807(3). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 14, 2022. Correction verified: Jul 19, 2022.

Written Feeding Instructions - Review and Update Every 30 Days

“Two infants not yet on table food did not have updated feeding instructions. Feeding instructions for one child was last completed 5/2022. Feeding instructions for another child was not dated, caregivers were not aware of when the instructions were written.”

Rule 746.2421(b). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 21, 2022. Correction verified: Jul 21, 2022.

Minimum Qualifications Child Care Center Employees and Caregivers - Affidavit

“Records were reviewed for 6 staff including the director. 5 staff did not have a notarized affidavit on file”

Rule 746.1105(3). Low, by Texas’s label. Correction date, as Texas HHSC recorded it: Jul 28, 2022. Correction verified: Jul 28, 2022.

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

“2 infants between 0-11 mo were observed sitting in a baby swing and bouncer for more than 15 mintues.”

Rule 746.2417(2)(B). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 27, 2022. Correction verified: May 10, 2022.

Infant May Not Sleep in a Restrictive Device

“A 3mo old was observed sleeping in a baby swing. The caregiver was unaware that the infant was sleep. The infant was removed after instructed by CCR. According to the caregiver, the infants were in the restrictive devices for at least 20 minutes.”

Rule 746.2426. High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 27, 2022. Correction verified: May 10, 2022.

Care Requirements for Toddlers - Free from Choking Objects That May Cause Choking in Infants or Toddlers

“A 19 mo old toddler was observed sleep in a crib with toys.”

Rule 746.2501(5). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 27, 2022. Correction verified: May 10, 2022.

Storage of Medication - Inaccessible to Children

“A container of diaper rash cream was observed in the crib with an 19mo old.”

Rule 746.3807(1). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 27, 2022. Correction verified: May 10, 2022.

Responsibilities of Caregivers - Know Children’s Names and Ages

“A caregiver was unaware of the ages of children in their care. When asked for the ages, the caregiver stated they guessed the age of the child and then stated they were unsure and did not want to say the wrong thing”

Rule 746.1203(3). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 27, 2022. Correction verified: May 10, 2022.

Child/ Caregiver Ratio - 13 or More Children

“A caregiver was observed with 8 children 3-21 months. The SAG was 0-11 mo. The caregiver was overratio by 4 children”

Rule 746.1601. Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 27, 2022. Correction verified: May 10, 2022.

Responsibilities of Caregivers - Know Group Responsible For

“The caregiver was observed with 11 children. When asked for the number of children in care there were 10 children present”

Rule 746.1203(2). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 19, 2022. Correction verified: Apr 27, 2022.

Director Presence Routine During Operating Hours

“The director is only present at the operation two days a week and is not routinely present during the hours of operation.”

Rule 746.1011. Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 19, 2022. Correction verified: Apr 27, 2022.

Responsibilities of Caregivers - Know Children’s Names and Ages

“A caregiver was unaware of the ages of children in their care. When asked for the ages, the caregiver stated they had just arrived and did not know.”

Rule 746.1203(3). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 19, 2022. Correction verified: Apr 27, 2022.

Child/ Caregiver Ratio - 13 or More Children

“A caregiver was observed with 11 children 4-23 months. The SAG was 18-23 mo. The caregiver was overratio by 3 children”

Rule 746.1601. Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 19, 2022. Correction verified: Apr 27, 2022.

Child/Caregiver Ratio - Combining Ages With 12 or Fewer Children

“There were 4 children ages 4m-15 mo old observed with children 18-23 mo. There were 24 total children in the building.”

Rule 746.1703. Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 19, 2022. Correction verified: Apr 27, 2022.

Maintenance of Building, Grounds and Equipment

“An infant was observed in a crib with a broken wheel. The crib was observed to be slanted.”

Rule 746.3407. Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 19, 2022. Correction verified: Apr 27, 2022.

Required Records Maintained and Made Available - Employees’ Attendance

“Sign-in/out logs for the director was requested and was not made available for review. According to the owner, a log of attendance for the director is not kept.”

Rule 746.801(5). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 19, 2022. Correction verified: Apr 27, 2022.

Director Presence Routine During Operating Hours

“The director is only present at the operation two days a week and is not routinely present during the hours of operation.”

Rule 746.1011. Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 20, 2022. Correction verified: Apr 19, 2022.

Required Records Maintained and Made Available - Employees’ Attendance

“Sign-in/out logs for the director was requested and was not made available for review. According to the owner, a log of attendance for the director is not kept.”

Rule 746.801(5). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 20, 2022. Correction verified: Apr 19, 2022.

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

“Cleaning chemicals in a spray bottle were observed on the table in reach of children.”

Rule 746.3407(12). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 21, 2022. Correction verified: Mar 24, 2022.

Responsibilities of Caregivers - Children in Control

“Several children were observed crawing under tables in the eating area. The children were observed crawling under the table for approx. 3 mintues before the caregivers were aware.”

Rule 746.1203(5). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 21, 2022. Correction verified: Mar 24, 2022.

Director Responsibilities - Employees Supervised

“Based on the information obtained during the investigation, as a result of the director’s frequent absence, the director was unaware of the caregivers’ activities prior to and when engaging in a physical altercation. The director failed to ensure all staff were supervised.”

Rule 746.1003(4). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 14, 2022. Correction verified: Apr 27, 2022.

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

“Based on he information obtained during the investigation, 2 caregivers engaged in a physical and verbal altercation with children present resulting in two children being pushed over chairs.”

Rule 746.1201(1). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 14, 2022. Correction verified: Apr 27, 2022.

Parental Communication - Situation that Placed a Child at Risk

“Based on the information obtained during the investigation, parents were not notified immediately that there was a situation that placed their children at risk. NOTE” Two parents were notified immediately, other parents were not notified until pick-up.”

Rule 746.307(b)(4). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 14, 2022. Correction verified: Apr 27, 2022.

Licensing Incident/Illness Report Form - Situations Placing Children at Risk

“based on the information obtained during the investigation, incident reports were not created for the 6 children present and placed at risk when two caregivers had a physical altercation”

Rule 746.701(5). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 18, 2022. Correction verified: Apr 29, 2022.

Report Number of Employees

“A review of the Employees Who Left Employment in 2021 data from February 23, 2022 revealed that the center had not reported the number of employees who left employment in 2021 by February 22, 2022 as required. NOTE: The operation reported the number of employees who left in 2021 after the deadline.”

Rule 746.303(b). Medium Low, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 14, 2022. Correction verified: Mar 14, 2022.

Required Equipment in Vehicles - Emergency Medical Information

“The operation did not have emergency medical authorization for 13 of 23 of the children being transported.”

Rule 746.5617(a)(2). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 11, 2022. Correction verified: Mar 16, 2022.

Required Equipment in Vehicles - Emergency Telephone Numbers for Each Child

“The operation did not have parent contacts or emergnecy contacts for 13 of the 23 of the children being transported.”

Rule 746.5617(a)(4). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 11, 2022. Correction verified: Mar 24, 2022.

Transportation Safety Training -Director and Employee Complete 2 Hours Annually

“Transportation training for the director was not made available for review. NOTE: Training for the owner/driver was reviewed and up-to-date”

Rule 746.1316(a). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 11, 2022. Correction verified: Mar 10, 2022.

Installation and Maintenance of Loose-fill Surfacing - Six Inches if Equipment 5 Ft or Less

“A play equipment with a height less than 5 feet did not have at least 6 inches of surfacing”

Rule 746.4907(a)(1). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 8, 2022. Correction verified: Apr 19, 2022.

AP Background check results - Must receive notification prior to allowing subject to be present at your operation

“A caregiver was observed to be present without notification of eligibility from the background check unit.”

Rule 745.641. High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jan 29, 2022. Correction verified: Jan 31, 2022.

Notification of Additional Services Offered

“During the inspection it was learned that the operation has been providing transportation services without notifing CCR of the additional services. NOTE: According to the owner, transportation began the second week of January 2022.”

Rule 746.301(7). High, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Jan 27, 2022.

Annual Fire Inspection - Before Initial Permit Issued and Every 12 Months

“The operation did not have a current fire inspection available for review. The last fire inspection was conducted 1/19/21”

Rule 746.5101(a). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 1, 2022. Correction verified: Mar 9, 2022.

Required Equipment in Vehicles - List of Children

“The operation did not have a list of all of the children being transported.”

Rule 746.5617(a)(1). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jan 27, 2022. Correction verified: Mar 9, 2022.

Required Equipment in Vehicles - Emergency Medical Information

“The operation did not have emergency medical authorization for anyl of the children being transported.”

Rule 746.5617(a)(2). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jan 27, 2022. Correction verified: Mar 9, 2022.

Required Equipment in Vehicles - Emergency Telephone Numbers for Each Child

“The operation did not have parent contacts or emergnecy contacts for any of the children being transported.”

Rule 746.5617(a)(4). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jan 27, 2022. Correction verified: Mar 9, 2022.

Required Equipment in Vehicles - First-aid Kit

“The first aid kit on the vehicle and was observed to be missing the following: Cotton balls Tweezers Scissors Tape Antiseptic solution/wipes Thermometer”

Rule 746.5617(a)(6). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jan 27, 2022. Correction verified: Mar 9, 2022.

Transportation Safety Training -Director and Employee Complete 2 Hours Annually

“Transportation training for the director and owner was not made available for review.”

Rule 746.1316(a). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Feb 27, 2022. Correction verified: Mar 9, 2022.

Installation and Maintenance of Loose-fill Surfacing - Six Inches if Equipment 5 Ft or Less

“A play equipment with a height less than 5 feet did not have at least 6 inches of surfacing”

Rule 746.4907(a)(1). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 1, 2022. Correction verified: Mar 9, 2022.

Sign-in and Sign-out Tracking System

“Of the 27 children present only 10 children were signed in. During the inspection, 2 children that left were not signed out”

Rule 746.631(a). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jan 27, 2022. Correction verified: Mar 9, 2022.

Children’s Products- Annual Certification

“The Children’s Product Safety certificate was not observed to be updated. The CPSC was last completed 1/20/21”

Rule 746.4135(b). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Feb 10, 2022. Correction verified: Mar 9, 2022.