Little Wishes and Big Dreams Playhouse Ltd

Requirements for Feeding Infants - Other Use of Handwashing Sink

“Rubber bibs were being washed in the hand sink in the infant room. This was corrected at inspection when the bibs were removed and the director had a discussion with the caregivers on not using the dedicated hand washing sink for washing bottles, toys, bibs, or other items.”

Rule 746.2419(8). Medium High, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Oct 9, 2026.

Children’s Records - Immunizations

“One out of ten children’s immunization records audited were not current.”

Rule 746.603(a)(4). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Oct 16, 2026. Correction verified: Oct 30, 2026.

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

“One caregiver without an eligible background check was present in the classroom with children and another staff. Note.This was corrected when the staff was asked to leave and they left the property.”

Rule 745.641. High, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Jun 15, 2026.

Diaper Changing Equipment - Smooth, Non-absorbent, Easy to Clean Surface

“A diaper changing mat was torn.”

Rule 746.3503(a). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: May 19, 2026. Correction verified: May 22, 2026.

Documented Annual Training Area - 24 Hours Required

“Two out of ten staff files did not have the full 24hrs of training at review.”

Rule 746.1309(a). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: May 26, 2026. Correction verified: May 28, 2026.

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

“The carbon monoxide detector was not documented as being completed.”

Rule 746.5537(a)(3). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Feb 27, 2026. Correction verified: Mar 23, 2026.

Infant Care Area Furnishings and Equipment -Use of Safety Straps

“A caregiver had an infant in a highchair without being strapped in the seat. *This was corrected at inspection*”

Rule 746.2407. Medium High, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Nov 21, 2025.

Fire Drill Monthly - Exit in 3 Minutes

“The operation did not have documented that they conducted the fire drill for the past month.”

Rule 746.5205(1). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Dec 5, 2025. Correction verified: Dec 16, 2025.

Responsibilities of Employees and Caregivers -Relate to Children

“Caregiver did not relate to a child with patience or courtesy with the interaction of making the child cry by grabbing them multiple times leaving a mark. *Dir terminated the caregiver after reviewing video*”

Rule 746.1201(2). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Sep 22, 2025. Correction verified: Oct 2, 2025.

Prohibited Punishments - Grabbing and Pulling

“Caregiver grabbed a 4yr old child by the arm leaving a mark on the arm. *Dir terminated the caregiver after reviewing video*”

Rule 746.2805(3). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Sep 22, 2025. Correction verified: Oct 1, 2025.

Training Requirements for Employees, Caregivers, and Directors - Pediatric First Aid with Rescue Breathing

“Based on the information gathered it was determined that one of the staff member’s first aid certificate was expired at the time of the incident.”

Rule 746.1301(a)(3)(A). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 28, 2025. Correction verified: Mar 28, 2025.

Required Equipment in Vehicles - Fire Extinguisher

“The operation had a fire extinguisher in the van, however the fire extinguisher was not secure in the van.”

Rule 746.5617(a)(5). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 26, 2025. Correction verified: Mar 19, 2025.

Prohibited Punishments - Grabbing and Pulling

“A caregiver grabbed a 2yr old child by the shoulder and chin hard enough to have the 2yr old off balance. *Management terminated the caregiver when it was brought to their attention*”

Rule 746.2805(3). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jan 23, 2025. Correction verified: Feb 4, 2025.

Supervision ensures each child?s safety, well-being, including physical proximity and auditory or visual awareness of each child?s on going activity

“A caregiver was unaware that a 3yr old child had acquired an aspirin from a first aid kit.”

Rule 746.1205(a)(4). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Nov 26, 2024. Correction verified: Dec 6, 2024.

Storage of Medication - Inaccessible to Children

“A 3yr old child had access to an aspirin from the first aid kit. *The child did not swallow the pill. All aspirin were removed from the first aid kits.”

Rule 746.3807(1). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Nov 26, 2024. Correction verified: Dec 6, 2024.

First Aid Kit - Inaccessible to Children

“A 3yr old child had access to the first aid kit.”

Rule 746.4001(5). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Nov 26, 2024. Correction verified: Dec 6, 2024.

Responsibilities of Caregivers - Know number of children responsible for

“A caregiver did not know how many children were in her care when asked by CCR.”

Rule 746.1205(a)(2). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Oct 16, 2024. Correction verified: Oct 24, 2024.

Supervision ensures each child?s safety, well-being, including physical proximity and auditory or visual awareness of each child?s on going activity

“A caregiver left a 3yr old child unattended in the restroom after a restroom break. Same caregiver left a different 3yr child on the indoor playground unattended while returning from that restroom break. *This caregiver is no longer with the operation. Operation had developed new plan with name to face checks.”

Rule 746.1205(a)(4). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Sep 26, 2024. Correction verified: Oct 8, 2024.

Nutrition and Food Service - Must not serve identified foods to allergic child

“An infant child was served food that was an identified allergy. *The operation has developed a new serving policy that has a picture of the child, what the allergy is, and action to take if exposed.”

Rule 746.3301(i). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Sep 26, 2024. Correction verified: Oct 8, 2024.

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

“The operation displayed poor judgement by not notifying the parent that their child was drug across the room by a caregiver to the outdoor playground.”

Rule 746.1201(1). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Sep 25, 2024. Correction verified: Oct 8, 2024.

Prohibited Punishments - Grabbing and Pulling

“A 3yr old child was grabbed with their hands over their head by a caregiver and drug across the room to the door leading to the outdoor playground. *Caregiver is not longer on staff.”

Rule 746.2805(3). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Sep 25, 2024. Correction verified: Oct 8, 2024.

Responsibilities of Caregivers - Share Information with Incoming Caregivers

“Based on evidence gathered, at least three caregivers who were responsible for a toddler at different times throughout the day, did not share pertinent information with each other regarding marks/bumbs seen on the toddler and incidents the toddler was involved in during their shift with the toddler.”

Rule 746.1203(10). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Aug 30, 2024. Correction verified: Sep 12, 2024.

Care Requirements for Toddlers -Same Caregiver Regularly

“Based on evidence gathered, staff did not ensure a toddler was cared for by their regular when they decided to move the toddler to another room with a different caregiver because the toddler’s assigned caregiver felt uncomfortable taking care of the toddler when the toddler was sick.”

Rule 746.2501(2). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Aug 30, 2024. Correction verified: Sep 12, 2024.

Illness Preventing Care - Child Cannot Participate Comfortably

“Based on evidence gathered, staff allowed an ill toddler to remain in care although the child had obvious symptoms of illness over the course of the course of multiple days and was inconsolable, which prevented him from participating in care. The operation did not follow their own written illness policy which stated they would require parent to pick up child if ill and/or if the child is “crying for longer than 1 hour without ability to be consoled.””

Rule 746.3601(1). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Aug 30, 2024. Correction verified: Sep 12, 2024.

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

“A bottle of air freshner was observed on top of the papertowel dispenser making it accessible to children in the pre-k. Note: This was CORRECTED AT INSPECTION when the air freshner was moved into a cabinet that was out of reach of children.”

Rule 746.3407(12). High, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Apr 12, 2024.

Required Admission Information - Special Needs Statement

“One child did not have a completed special needs statement.”

Rule 746.605(13). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 15, 2024. Correction verified: Apr 23, 2024.

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

“A caregiver was seen transporting children without an active background check.”

Rule 745.641. High, by Texas’s label. Correction date, as Texas HHSC recorded it: Feb 23, 2024. Correction verified: Mar 4, 2024.

Prohibited Punishments - Humiliating, Rejecting, Yelling

“Based on information gathered in the investigation, a caregiver was yelling at children as a form of discipline.”

Rule 746.2805(5). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 28, 2024. Correction verified: Apr 12, 2024.