Hill & Dale Child Development Center

NAC 414

“1. A carpeted floor or rug on a floor that is too large to wash in a washing machine must be vacuumed not less than one time each day or more often if necessary and cleaned not less than one time every 3 months or more often if necessary. If the carpeted floor or rug is cleaned by a member of the staff of the facility using a carpet cleaning machine, the Health Division may require the carpeted floor or rug to be professionally cleaned if the carpeted floor or rug does not appear to be clean. 2. Each floor of a facility that is not carpeted must be swept and mopped not less than one time each day or more often if necessary. 3. When cleaning a nonporous surface in a facility, including, without limitation, cleaning toys, cribs, tables, high chairs and surfaces used to change diapers, the staff of the facility shall: (a) Clean the surface first with soap and water to remove any dirt or debris; and (b) Disinfect the surface with a disinfecting agent. 4. The disinfecting agent used pursuant to subsection 3 must consist of: (a) One-fourth of a cup of liquid chlorine bleach added to 1 gallon of water that is prepared fresh daily and kept in a closed container; (b) One tablespoon of liquid chlorine bleach added to 1 quart of water that is prepared fresh daily; or (c) A solution that is approved by the appropriate state or local agency and is at least as effective as the solutions described in paragraphs (a) and (b). Carpeted floors/rugs too large for washing were not cleaned once every three months or more often if necessary. Please ensure cleaning of carpets and rugs occurs as required and document dates of cleaning.”

NAC 372

“1. An easily understandable chart describing first aid and emergency treatment must be available in each facility. A well-stocked first-aid kit must be readily available at all times. 2. Every licensee of a facility other than an accommodation facility shall have written provisions for: (a) Consulting with physicians or registered nurses regarding the health of the children; (b) Obtaining assistance in developing and maintaining current health policies; and (c) Informing members of the staff on matters of health affecting the children, including dental health and personal cleanliness and care. 3. A written directory of emergency health services must be readily available in the facility. The directory must include the name, address and telephone number of: (a) A hospital, clinic or other constantly staffed medical facility; and (b) A physician or registered nurse to be called for each child if the parents of the child have signed a written agreement stating that the person is acceptable. A well-stocked first-aid kit was not available. Provide a first-aid kit that is adequately stocked.”

NAC 280.7

“7. The State Fire Marshal or a designee thereof shall, at least annually: (a) Enter and inspect every building or the premises of each facility; and (b) Observe and make recommendations regarding the drills conducted pursuant to subsection 3.”

NAC 302

“1. A licensee of a child care facility shall not knowingly appoint a person as director of the facility or appoint or permit the appointment of a person as an employee or volunteer at the facility if the person has been convicted of child abuse or neglect or any other crime involving physical harm to a person or if a criminal action for such a crime is pending against the person. 2. The staff of a child care facility must be able to: (a) Work with children without recourse to physical punishment or psychological abuse; (b) Communicate with children and their parents; (c) Praise and encourage children and provide them with a variety of opportunities for learning and social experiences; and (d) Recognize and eliminate hazards to the safety of children. Facility failed to recognize and eliminate the following hazards for the safety of children as evidenced by the following:, Facility failed to recognize and eliminate the following hazards for the safety of children as evidenced by the following:”

NAC 250.4

“4. The play area of each facility must: (a) Be fenced or enclosed in a manner that prevents the unsupervised departure of children from the area; (b) Have an adequate drainage system; (c) Be free of hazards, debris and trash; (d) If it is an outdoor play area, provide, during the months of April through September, a shade area or shade areas that are at least equal in size to the product of 5 square feet multiplied by the total number of children in the outdoor play area; (e) Have appropriate, as determined by the Division, depths and perimeters of resilient surfacing underneath and surrounding any elevated play equipment; (f) Have adequate safety barriers around any elevated platforms; (g) Not have any dangerous or poisonous plants or other vegetative matter located within the boundaries of the play area or in an area that is accessible to children from the play area; (h) Not be in a location where any bodies of water are accessible to children; and (i) If it has playground equipment, have only equipment that is: (1) In good repair; (2) Designed and constructed to minimize injury; (3) Compatible with the age of the children in the care of the facility; (4) Spaced to reduce accidents; and (5) Securely anchored. The facility was found to have hazards as listed below. Ensure that the play area is free of hazards, debris and trash.”

NAC 302

“1. A licensee of a child care facility shall not knowingly appoint a person as director of the facility or appoint or permit the appointment of a person as an employee or volunteer at the facility if the person has been convicted of child abuse or neglect or any other crime involving physical harm to a person or if a criminal action for such a crime is pending against the person. 2. The staff of a child care facility must be able to: (a) Work with children without recourse to physical punishment or psychological abuse; (b) Communicate with children and their parents; (c) Praise and encourage children and provide them with a variety of opportunities for learning and social experiences; and (d) Recognize and eliminate hazards to the safety of children. Facility failed to recognize and eliminate the following hazards for the safety of children as evidenced by the following:”

NAC 430

“1. Each facility, including, without limitation, a family home and a group home, shall have an early care and education program. 2. Each facility described in subsection 1 shall develop a written assessment plan which is designed to, without limitation: (a) Identify the interests and needs of each child enrolled in the facility; (b) Describe the developmental and educational progress of each child enrolled in the facility who is not attending public or private elementary school; (c) Identify the need for and referral of a child enrolled in the facility for developmental screening and the referral of the child for diagnostic assessment, if appropriate; (d) Describe the methodology for developing curriculum for the children enrolled in the facility; (e) Adapt teaching practices and the environment to the children enrolled in the facility; (f) Facilitate the early care and education program required pursuant to subsection 1; and (g) Promote communication with the family of a child enrolled in the facility. 3. In addition to the written assessment plan which is developed pursuant to subsection 2, each facility described in subsection 1 shall, within 3 months after a child enrolls in the facility, assess the child by use of, without limitation, portfolios, observations, checklists, rating scales and screening tools. Such an assessment must be repeated biannually thereafter to monitor and support the learning and development of each child enrolled in the facility. 4. Each facility described in subsection 1 shall develop a written plan of curriculum for the children enrolled in the facility. The plan must: (a) Be made available for parental review; (b) Be prepared before the early care and education program becomes effective; (c) Be kept on file at the facility for at least 1 year; (d) Include a program of speaking and listening to English; (e) Integrate age appropriate key areas of instruction, including, without limitation, literacy, mathematics, science, social studies, creative expression and the arts, and health and safety; (f) Incorporate instruction, concepts and activities that foster the social, emotional, physical, linguistic and cognitive development of children; and (g) Provide for the involvement of parents of the children enrolled in the facility in learning activities at the facility and at home. 5. Each facility described in subsection 1 shall provide materials and equipment to carry out the written plan of curriculum developed pursuant to subsection 4 that: (a) Reflect the lives of the children and the families of the children enrolled in the facility; (b) Reflect the diversity of the children in our society with regard to the gender, age, native language, ethnicity, culture and abilities of the children enrolled in the facility; (c) Provide for the safety of the children enrolled in the facility while being appropriately challenging for the children; (d) Encourage the children enrolled in the facility to explore, experiment and discover new information and ideas; (e) Promote action on the part of the children enrolled in the facility and interaction among the children enrolled in the facility; (f) Are organized in a manner which facilitates independent use of the materials and equipment by a child enrolled in the facility; (g) Are rotated to reflect changes in the curriculum and to accommodate the different interests and skill levels of the children enrolled in the facility; (h) Allow for a variety of uses; and (i) Accommodate the special needs of the children enrolled in the facility. The facility failed to ensure assessments were completed at least twice a year and within 3 months of enrollment. Please ensure assessments are completed for all children present, with the exception of school age children, at least twice a year and within 3 months of enrollment.”

NAC 340

“1. Procedures for admission must provide the caregiver with sufficient information and instruction from the parents to enable the caregiver to prepare a record and to make decisions or act on behalf of the child. 2. Before the admission of a child to a facility, the parent shall give the following information to the caregiver: (a) The child ' s full legal name, date of birth, current address and preferred name; (b) The name, address and telephone number of each parent responsible for the child and any special instructions needed to reach the parent during the hours the child is in the facility; (c) The name, address and telephone number of any person who can assume responsibility for the child and is authorized to take the child from the facility if the parents cannot be reached; (d) Information concerning the health of the child, including any special needs of the child; and (e) A written authorization signed by a parent which allows emergency surgical and medical care. 3. The caregiver shall, unless the facility is an accommodation facility: (a) Make a record for each child that includes the date the record was prepared and the date the child is scheduled to attend the facility; and (b) Maintain each record in good order. The following children are missing signed transportation permission forms. Secure missing form for the children and submit to licensing., The facility did not ensure that information provided by the parent before admission included a written authorization signed by a parent which allows emergency and medical care. Secure missing authorization for the child(ren) as noted on the supplement.”

NRS 230

“Certificate of immunization prerequisite to admission to child care facility; conditional admission; report to Health Division. Except as otherwise provided in NRS 432A.235 for accommodation facilities: 1. Except as otherwise provided in subsection 3 and unless excused because of religious belief or medical condition, a child may not be admitted to any child care facility within this State, including a facility licensed by a county or city, unless the parents or guardian of the child submit to the operator of the facility a certificate stating that the child has been immunized and has received proper boosters for that immunization or is complying with the schedules established by regulation pursuant to NRS 439.550 <NRS-439.html> for the following diseases: (a) Diphtheria; (b) Tetanus; (c) Pertussis if the child is under 6 years of age; (d) Poliomyelitis; (e) Rubella; (f) Rubeola; and (g) Such other diseases as the local board of health or the State Board of Health may determine. 2. The certificate must show that the required vaccines and boosters were given and must bear the signature of a licensed physician or his or her designee or a registered nurse or his or her designee, attesting that the certificate accurately reflects the child ' s record of immunization. 3. A child whose parent or guardian has not established a permanent residence in the county in which a child care facility is located and whose history of immunization cannot be immediately confirmed by a physician in this State or a local health officer, may enter the child care facility conditionally if the parent or guardian: (a) Agrees to submit within 15 days a certificate from a physician or local health officer that the child has received or is receiving the required immunizations; and (b) Submits proof that the parent or guardian has not established a permanent residence in the county in which the facility is located. 4. If a certificate from the physician or local health officer showing that the child has received or is receiving the required immunizations is not submitted to the operator of the child care facility within 15 days after the child was conditionally admitted, the child must be excluded from the facility. 5. Before December 31 of each year, each child care facility shall report to the Health Division of the Department, on a form furnished by the Division, the exact number of children who have: (a) Been admitted conditionally to the child care facility; and (b) Completed the immunizations required by this section. The below listed children did not have a current immunization record or approved exemption on file at the facility. Obtain and file a current immunization record for the children listed. Director is recommended to sign up for WebIZ training in order to have access to the most up-to-date immunization records on-line. Discard old immunization records upon obtaining most current.”

NAC 360

“1. The licensee of a facility shall not disclose to any person who is not a member of the staff of the facility or a member of the licensing staff of the Health Division information pertaining to any child, unless: (a) The parent has given written permission for the disclosure; or (b) There is an emergency as determined by the director or the member of the staff who is in charge at the time of the emergency. 2. The licensee of a facility shall have available forms which allow a parent to release information pertaining to his or her child. The facility failed to have forms available which allow a parent to release information pertaining to his child. Make release of information forms available for the following children:, Based on interview”

NRS 178

“Child care facility required to maintain certain information; reporting of information to parents and guardians; notice of right to information. 1. A child care facility shall maintain a copy of: (a) The license issued to the facility by the Health Division or an agency for the licensing of child care facilities established by a county or incorporated city; (b) Any summaries of complaints provided to the facility pursuant to subsection 3 of NRS 432A.190; (c) The report of any investigation conducted with respect to the complaints; and (d) The report of any disciplinary action taken against the facility pursuant to NRS 432A.190. 2. The information maintained pursuant to subsection 1 must be provided in the form prescribed pursuant to subsection 3: (a) To the parent or guardian of a child who enrolls the child in the facility, at or before the time of enrollment. (b) To the parent or guardian of a child, upon request, who is considering enrolling the child in the facility. (c) In the case of disciplinary action taken pursuant to NRS 432A.190, to the parents or guardians of all children admitted to the facility. Notice of disciplinary action must be provided to the parents or guardians of the children admitted to the facility within 3 working days after receipt by the licensed child care facility. 3. The Health Division shall develop a standard form for reporting the information required to be provided pursuant to subsection 2. The information reported on the form must include all required information for the 12-month period ending on the last day of the month immediately preceding the month in which the information is provided. 4. The Health Division and every agency for the licensing of child care facilities established by a county or incorporated city shall inform persons seeking information concerning child care facilities of their right to information pursuant to this section. The facility failed to have a completed complaint review (NRS-178) on file and signed by parents/guardians for the following children:”

NAC 320.1

“1. Except as otherwise provided in NRS 432A.177 , within the first 2 weeks after commencing employment, newly employed members of the staff of a facility must be given a written and oral orientation program and be trained in the policies, procedures and programs of the facility by the director or a designee trained by the director. The orientation must address, at a minimum: (a) Any regulatory requirements that govern the facility; (b) The goals and philosophy and the policies and procedures of the facility; (c) Any planned programs or activities of the facility; (d) The policies and practices of the facility for relating to parents; (e) Meal patterns and food-handling policies and practices of the facility; (f) Dealing with occupational health hazards for caregivers, including, without limitation, paying attention to the physical health and emotional demands of the job and being aware of any special considerations required by a caregiver who is pregnant; (g) The emergency health and safety procedures of the facility; and (h) The general health and safety policies and procedures of the facility, including, without limitation, policies and procedures concerning: (1) Hand-washing techniques and requirements; (2) Techniques for diapering and for assisting in the use of a toilet if care is provided to children in diapers or children needing help with using a toilet, including, without limitation, techniques for the disposal of diapers and for changing diapers; (3) Identifying hazards and methods for preventing injuries; (4) Techniques for preparing, serving and storing food for employees who are involved in any of the activities concerning food for children at the facility; (5) Excluding a child from the facility because the child has an illness, and the manner in which illnesses are transmitted between persons; (6) Methods for preparing formula if formula is prepared at the facility; (7) Any precautions and other measures that should be taken to prevent exposure to blood and other bodily fluids, and policies and procedures to follow in the event of exposure to blood or other bodily fluids; and (8) The administration of medication. New employees were not given a written and oral orientation and training in the policies, procedures, and programs of the facility within the first 2 weeks after commencing employment. Provide orientation and training as required. Please provide a copy of the orientation to Child Care Licensing and keep a copy in the employee's file., Based on interview”

NAC 302

“1. A licensee of a child care facility shall not knowingly appoint a person as director of the facility or appoint or permit the appointment of a person as an employee or volunteer at the facility if the person has been convicted of child abuse or neglect or any other crime involving physical harm to a person or if a criminal action for such a crime is pending against the person. 2. The staff of a child care facility must be able to: (a) Work with children without recourse to physical punishment or psychological abuse; (b) Communicate with children and their parents; (c) Praise and encourage children and provide them with a variety of opportunities for learning and social experiences; and (d) Recognize and eliminate hazards to the safety of children. Facility failed to recognize and eliminate the following hazards for the safety of children as evidenced by the following:”

NAC 280.5

“5. The director of the facility shall maintain a daily sign-in sheet that includes: (a) The first and last names of staff and children; and (b) The times of arrival and departure for staff and children The facility failed to maintain a daily sign-in sheet that included the times of arrival and departure for staff and children. To ensure times are consistently recorded, please provide instruction to staff and parents and monitor the daily sign-in sheets.”

NAC 250.4

“4. The play area of each facility must: (a) Be fenced or enclosed in a manner that prevents the unsupervised departure of children from the area; (b) Have an adequate drainage system; (c) Be free of hazards, debris and trash; (d) If it is an outdoor play area, provide, during the months of April through September, a shade area or shade areas that are at least equal in size to the product of 5 square feet multiplied by the total number of children in the outdoor play area; (e) Have appropriate, as determined by the Division, depths and perimeters of resilient surfacing underneath and surrounding any elevated play equipment; (f) Have adequate safety barriers around any elevated platforms; (g) Not have any dangerous or poisonous plants or other vegetative matter located within the boundaries of the play area or in an area that is accessible to children from the play area; (h) Not be in a location where any bodies of water are accessible to children; and (i) If it has playground equipment, have only equipment that is: (1) In good repair; (2) Designed and constructed to minimize injury; (3) Compatible with the age of the children in the care of the facility; (4) Spaced to reduce accidents; and (5) Securely anchored. The facility was found to have hazards as listed below. Ensure that the play area is free of hazards, debris and trash.”

NAC 414

“1. A carpeted floor or rug on a floor that is too large to wash in a washing machine must be vacuumed not less than one time each day or more often if necessary and cleaned not less than one time every 3 months or more often if necessary. If the carpeted floor or rug is cleaned by a member of the staff of the facility using a carpet cleaning machine, the Health Division may require the carpeted floor or rug to be professionally cleaned if the carpeted floor or rug does not appear to be clean. 2. Each floor of a facility that is not carpeted must be swept and mopped not less than one time each day or more often if necessary. 3. When cleaning a nonporous surface in a facility, including, without limitation, cleaning toys, cribs, tables, high chairs and surfaces used to change diapers, the staff of the facility shall: (a) Clean the surface first with soap and water to remove any dirt or debris; and (b) Disinfect the surface with a disinfecting agent. 4. The disinfecting agent used pursuant to subsection 3 must consist of: (a) One-fourth of a cup of liquid chlorine bleach added to 1 gallon of water that is prepared fresh daily and kept in a closed container; (b) One tablespoon of liquid chlorine bleach added to 1 quart of water that is prepared fresh daily; or (c) A solution that is approved by the appropriate state or local agency and is at least as effective as the solutions described in paragraphs (a) and (b). Carpeted floors/rugs too large for washing were not cleaned once every three months or more often if necessary. Please ensure cleaning of carpets and rugs occurs as required and document dates of cleaning.”

NAC 380.7

“7. Meals may be brought from home to a facility for a child to consume at the facility. The bag or other container used to bring the meal to the facility must be labeled with the child ' s first and last name. A facility shall inform the parents of each child who is cared for in the facility that perishable items must be stored or packed in a manner that maintains the temperature of the contents. Based on”

NAC 290.2

“2. Each licensee of a facility shall have a policy of insurance for protection against liability to third persons. A certificate of insurance must be furnished by the licensee of a facility to the Division as evidence that the policy is in force. Each policy must contain a provision which requires the insurer to notify the Division before cancellation or nonrenewal of the policy. The licensee shall notify the Division if there is a lapse in the insurance coverage required by this subsection. The policy of insurance must be maintained at the facility. Any government, governmental agency or political subdivision of a government which operates a child care facility and is self- insured is not required to furnish a certificate of insurance to the Division. The facility was not able to provide Child Care with a current certificate of insurance as evidence of liability insurance.”

NRS 230

“Certificate of immunization prerequisite to admission to child care facility; conditional admission; report to Health Division. Except as otherwise provided in NRS 432A.235 for accommodation facilities: 1. Except as otherwise provided in subsection 3 and unless excused because of religious belief or medical condition, a child may not be admitted to any child care facility within this State, including a facility licensed by a county or city, unless the parents or guardian of the child submit to the operator of the facility a certificate stating that the child has been immunized and has received proper boosters for that immunization or is complying with the schedules established by regulation pursuant to NRS 439.550 <NRS-439.html> for the following diseases: (a) Diphtheria; (b) Tetanus; (c) Pertussis if the child is under 6 years of age; (d) Poliomyelitis; (e) Rubella; (f) Rubeola; and (g) Such other diseases as the local board of health or the State Board of Health may determine. 2. The certificate must show that the required vaccines and boosters were given and must bear the signature of a licensed physician or his or her designee or a registered nurse or his or her designee, attesting that the certificate accurately reflects the child ' s record of immunization. 3. A child whose parent or guardian has not established a permanent residence in the county in which a child care facility is located and whose history of immunization cannot be immediately confirmed by a physician in this State or a local health officer, may enter the child care facility conditionally if the parent or guardian: (a) Agrees to submit within 15 days a certificate from a physician or local health officer that the child has received or is receiving the required immunizations; and (b) Submits proof that the parent or guardian has not established a permanent residence in the county in which the facility is located. 4. If a certificate from the physician or local health officer showing that the child has received or is receiving the required immunizations is not submitted to the operator of the child care facility within 15 days after the child was conditionally admitted, the child must be excluded from the facility. 5. Before December 31 of each year, each child care facility shall report to the Health Division of the Department, on a form furnished by the Division, the exact number of children who have: (a) Been admitted conditionally to the child care facility; and (b) Completed the immunizations required by this section.”

NAC 200.4

“4. Fingerprints must be taken and applications for investigations must be made by: (a) Every employee or a resident of the facility who is 18 years of age or older, other than a resident who remains under the jurisdiction of a court pursuant to NRS 432B.594, and every volunteer of the facility who is 18 years of age and or older, other than a parent of a child who attends the facility, within 24 hours after the date of hiring or his or her presence in the facility, and every 5 years thereafter. (b) Every participant in an outdoor youth program who is 18 years of age or older within 24 hours after the participant begins participating in the program and every 5 years thereafter. (b) An applicant at the time that his or her application is submitted for licensure, and then at least once every 5 years after the license is issued. (d) A licensee every 5 years after the date his or her license is originally issued.”