The Nest School San Antonio

Training Requirements for Employees, Caregivers, and Directors - 24 Annual training

“Eight of the staff files were missing required 24 hours training. Two of the staff files were missing affidavit.”

Rule 746.1301(a)(5)(A). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Aug 15, 2025. Correction verified: Aug 29, 2025.

Responsibilities of Caregivers - Know number of children responsible for

“At time of inspection a PreK caregiver stated they had 13 children when the class had 10.”

Rule 746.1205(a)(2). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Feb 21, 2025. Correction verified: Mar 5, 2025.

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

“It was determined during the course of the investigation that the director demonstrated poor judgement when she documented that she had conducted fire drills that were never conducted, thereby falsifying documentation at the operation.”

Rule 746.1201(1). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 26, 2025. Correction verified: Apr 9, 2025.

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

“At time of inspection, two Epi-Pens were observed in a PreK restroom not stored in original contain and no labels.”

Rule 746.3805(b)(1). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Feb 19, 2025. Correction verified: Feb 21, 2025.

Fire Drill Monthly - Exit in 3 Minutes

“During the investigation, it was confirmed that the operation was not conducting monthly fire drills as required by minimum standards.”

Rule 746.5205(1). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 26, 2025. Correction verified: Apr 9, 2025.

Safety - Areas Free From Hazards

“At time of inspection childrens restroom was observed to be used as storage.”

Rule 746.3701. Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Feb 14, 2025. Correction verified: Feb 19, 2025.

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

“At time of inspection, a childs medication was observed to not be in original container.”

Rule 746.3805(b)(1). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Feb 14, 2025. Correction verified: Feb 19, 2025.

Emergency Preparedness Plan - Evacuation, relocation, and sheltering/lock-down procedures

“At time of inspection, emergency preparedness plan did not include how they would evacuate children with limited mobility. At time of inspection, emergency preparedness plan did not state alternative relocation. This was corrected at inspection.”

Rule 746.5202(1). Medium High, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Jan 30, 2025.

Safety - Electrical Outlets Covered

“At time of inspection electrical outlets in the new building were observed to not have protective covers. This was corrected at inspection.”

Rule 746.3701(1). Medium High, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Sep 11, 2024.

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

“It was determined that poor judgment was used when a parent was not given pertinent information regarding their child’s health.”

Rule 746.1201(1). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jun 10, 2024. Correction verified: Jun 18, 2024.

Report Situation Placing Children at Risk

“The operation failed to report to CCR staff after a child was served a food item identified on his allergy plan.”

Rule 746.305(a)(6). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jun 10, 2024. Correction verified: Jun 18, 2024.

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

“A child was served a food item that is identified on the child’s food allergy plan.”

Rule 746.3301(i). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jun 10, 2024. Correction verified: Jun 18, 2024.

Documented Annual Training- Required Content

“A caregiver did not have current training in required topics (Medication administration and Preventing and responding to emergencies due to food or an allergic reaction).”

Rule 746.1309(e). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Jun 10, 2024. Correction verified: Jun 18, 2024.

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

“At time of inspection last fire inspection was conducted on 9/27/22.”

Rule 746.5101(a). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 8, 2024. Correction verified: Feb 27, 2024.

Child-Care Center Must be Equipped with a Working Carbon Monoxide (CO) Detection System

“At time of inspection, operation did not have a carbon monoxide detector.”

Rule 746.5531. High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 8, 2024. Correction verified: Feb 27, 2024.

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

“At time of inspection the loose fill under the swing area was not adequate as ground was visible.”

Rule 746.4907(d). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 15, 2024. Correction verified: Feb 29, 2024.

Required Admission Information - Water Activity Permission

“At time of inspection six out of six children files did not have if children can swim without assistance, need a life jacket or if child has a condition that would put them at risk while swimming.”

Rule 746.605(10). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Mar 8, 2024. Correction verified: Mar 8, 2024.