Avance San Antonio Cdc Frank Garrett

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

“Based on the four-minute video footage the caregivers did not demonstrate good judgment by placing a weighted blue Coco Melon backpack on the back of the child over the back of their chair preventing that child from standing up. In addition to placing this weighted blue Coco Melon backpack and strapping it around the child?s waist while in centers.”

Rule 746.1201(1). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Nov 10, 2023. Correction verified: Nov 13, 2023.

Responsibilities of Caregivers - Interact positively with children

“Based on the video footage on 9.19.23 the caregivers were observed not positively or actively interacting with the children as they we seen talking longer than an hour amongst themselves.”

Rule 746.1203(5). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Sep 22, 2023. Correction verified: Oct 4, 2023.

Care Requirements for Toddlers - Holding and Comforting

“Based on the video footage on 9.19.23 the caregiver was not observed giving individual attention, holding and comforting a child that was crying after being pushed by another child.”

Rule 746.2501(4). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Sep 22, 2023. Correction verified: Oct 4, 2023.

Food Service and Preparation Requirement - Use Sanitary Holders

“Based on the video footage on 9.19.23 a snack was being provided to the children on a bare table.”

Rule 746.3317(6). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Sep 22, 2023. Correction verified: Oct 4, 2023.

Sanitize Tables Tops, Furniture and Similar Equipment

“Based on the video footage on 9.19.23 the caregivers were not observed sanitizing tables before providing the children a snack.”

Rule 746.3407(11). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Sep 22, 2023. Correction verified: Oct 4, 2023.

Employee Handwashing After Diapering a Child

“Based on the video footage on 9.19.23 the caregivers were not observed handwashing their hands or the children between diaper changing.”

Rule 746.3415(4). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Sep 22, 2023. Correction verified: Oct 4, 2023.

Positive Methods of Discipline and Guidance - Brief Supervised Separation

“Based on the video footage on 9.19.23 a child was observed being placed in a chair for a long period of time not appropriate for the child’s age.”

Rule 746.2803(4)(D). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Sep 22, 2023. Correction verified: Oct 4, 2023.

Positive Methods of Discipline and Guidance - Redirecting Behavior

“Based on the video footage on 9.19.23 a caregiver was observed lifting a child by their forearm, pulling a child off the table by their leg when redirecting.”

Rule 746.2803(4)(C). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Sep 22, 2023. Correction verified: Oct 4, 2023.

Documented Annual Training Area - 24 Hours Required

“One of the six staff files were missing 24 hours of training from May 2022-2023.”

Rule 746.1309(a). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Aug 20, 2023. Correction verified: Jul 25, 2023.

Director Annual Training 30 Hours Required

“The director is missing the 30 hours of the annual training.”

Rule 746.1311(a). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Aug 20, 2023. Correction verified: Aug 3, 2023.

Reduction of child/caregiver naptime ratio by 50% allowed, If 13 or more children in care, children are 18 mo. or older and other standards met

“During naptime in Group 4 one caregiver was supervising nine children with the youngest being 13 months and the oldest being 21 months old. NOTE: This was corrected when another caregiver was called into the classroom.”

Rule 746.1613(a). Medium, by Texas’s label. Corrected during the inspection. Correction date, as Texas HHSC recorded it: Jul 20, 2023.

Responsibilities of Caregivers - Supervision of Children

“Based upon information gathered and interviews conducted supervision was determined to have occurred after a 19-month-old child was found in the classroom unsupervised.”

Rule 746.1203(4). High, by Texas’s label. Correction date, as Texas HHSC recorded it: Jan 23, 2023. Correction verified: Jan 26, 2023.

Immunization Records, Exceptions, and Exemptions Current

“One of the six children did not have a current immunization record on file.”

Rule 746.613(b). Medium High, by Texas’s label. Correction date, as Texas HHSC recorded it: Aug 18, 2022. Correction verified: Aug 11, 2022.

Documented Annual Training- Required Content

“Director did not have required training on file for the following; SID, brain development, and head trauma Handling and storing and Building grounds and premises”

Rule 746.1309(e). Medium, by Texas’s label. Correction date, as Texas HHSC recorded it: Sep 11, 2022. Correction verified: Sep 13, 2022.