First Start Child Care #2

Responsibilities of Caregivers - Intervene to ensure each child’s safety

“A caregiver was engaged in duties unrelated to caring for children, while a child was resting in a room unsupervised. A child was observed going to the bathroom unsupervised. This was corrected when the caregiver returned to the room.”

Rule 746.1205(a)(5). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 22, 2026. Correction verified: May 4, 2026.

Floors, ceilings and Walls in Good Repair and Clean

“The carpets in two of the classrooms were not clean. Stains were observed on the carpets and on some of the cloth seating chairs.”

Rule 746.3407(9). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: May 1, 2026. Correction verified: May 4, 2026.

Safety - Areas Free From Hazards

“The wall outlets in each of the classroom did not have protective covers, the outdoors playground had toys that were broken and tires with standing water. The tires did not have holes drilled in them to allow the water to drain. The wall outlets were covered during the inspection.”

Rule 746.3701. Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 30, 2026. Correction verified: May 4, 2026.

First Aid Kit - Incomplete Kit

“The first aid kit was observed and did not have tweezers, band aids, thermometer, antiseptic wipes or gloves. This was corrected during the inspection when the supplies were added to the kit.”

Rule 746.4003(a). Medium, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Apr 22, 2026.

Installation of Smoke Detectors

“Battery operated smoke add carbon monoxide detectors were not present in 2 of the classrooms where care was being provided.”

Rule 746.5317. High, by Texas’s label. Correction date, as Texas HHSC recorded it: Oct 31, 2025. Correction verified: Oct 23, 2025.

Documented Annual Training Area - 24 Hours Required

“Training records were deficient for the 24 annual clock hours.”

Rule 746.1309(a). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Oct 24, 2025. Correction verified: Oct 23, 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 staff member sent an older child in care to another classroom unsupervised. The child went to retrieve something in the room for the staff member.”

Rule 746.1205(a)(4). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jan 9, 2026. Correction verified: Jan 9, 2026.

Infant Care Area Furnishings and Equipment - Hand-washing Sink

“A caregiver was observed during diaper changing in a classroom without a hand washing sink. This was corrected during the inspection when the caregiver took the child to the bathroom to wash hands.”

Rule 746.2405(4). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 25, 2025. Correction verified: May 6, 2025.

Parent right to enter and examine operation without advance notice

“Parent’s rights notices were not observed in the children’s records.”

Rule 746.521(1). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: May 2, 2025. Correction verified: Apr 29, 2025.

Determining Child/Caregiver Ratios - Basis

“A classroom was observed out of ratio by 3 children when a caregiver left the room. This was corrected when the caregiver returned to the room. The classroom was observed out of ratio by one child. This was corrected when the child was taken to another classroom bringing the room into ratio.”

Rule 746.1507(1). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 25, 2025. Correction verified: May 6, 2025.

Written Feeding Instructions - Review and Update Every 30 Days

“The written feeding instructions had not been reviewed, or updated as of today’s date.”

Rule 746.2421(b). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 30, 2025. Correction verified: Apr 29, 2025.

First Aid Kit Incomplete - Tweezers

“The first aid kit was incomplete for tweezers. The kit also had expired supplies. The expired supplies was corrected during the inspection when the director removed the items.”

Rule 746.4003(a)(8). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Apr 27, 2025. Correction verified: Apr 29, 2025.

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

“A child was observed to have leftover chewed food in the play yard, This was corrected when the caregiver removed the food from the play yard”

Rule 746.2401(6). High, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Aug 23, 2024.

Children’s Records - Health Statement

“4 of the records evaluated did not have parent signatures or the health statement signed by the physician.”

Rule 746.603(a)(3). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Sep 6, 2024. Correction verified: Sep 11, 2024.

Required Personnel Records - Required Affidavit (Form 2985)

“One staff did not have the required signed employment affidavit.”

Rule 746.901(4). Medium Low, by Texas’s label. Correction date, as Texas HHSC recorded it: Aug 30, 2024. Correction verified: Aug 26, 2024.

Infant May Not Sleep in a Restrictive Device - Remove the infant from the device and place the infant in a crib as soon as possible

“A child was observed asleep in a restrictive device. The child did not have the required sleep exception form.”

Rule 746.2426(a)(2). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Nov 16, 2023. Correction verified: Dec 1, 2023.

Safety Requirements for Active Play Equipment - No Pinch, Crush, or Shear Points

“During the walk through of the operation, broken and damaged toys were observed in the play space. This was corrected during the inspection when all of the broken toys were removed.”

Rule 746.4601(7). High, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Nov 16, 2023.

Adequate Lighting During Naptime

“There was insufficient lighting observed during nap time in the room where children were napping. The caregiver was unable to visibly see the children’s faces to be able to intervene in the event of an emergency. This was corrected during the inspection when the caregiver turned on the light and opened the door to the adjoining bathroom.”

Rule 746.2911. Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Nov 16, 2023. Correction verified: Dec 1, 2023.

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

“A caregiver did not use good judgment for a child in care. The caregiver knowingly placed a child at risk of injury by pushing the child and causing the child to lose balance and fall.”

Rule 746.1201(1). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jan 8, 2024. Correction verified: Jan 24, 2024.

AP Responsibilities of Employees and Caregivers -Ensure No Child Abused, Neglected, or Exploited

“During a DFPS investigation there was sufficient evidence to support a child was abused.”

Rule 746.1201(4). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jan 8, 2024. Correction verified: Jan 24, 2024.

Prohibited Punishments - Grabbing and Pulling

“A caregiver was observed grabbing a child in care roughly by the arms and lifting the child from the table and floor on two separate occasions.”

Rule 746.2805(3). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jan 8, 2024. Correction verified: Jan 24, 2024.

Responsibilities of Caregivers - Interact positively with children

“A caregiver was observed not interacting positively with a child in care. The caregiver did not provide care, check the child injury or console a child after the child had fallen to the floor, sustaining a possible injury.”

Rule 746.1203(5). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jan 8, 2024. Correction verified: Jan 24, 2024.