Neverland Nursery & Navigational Academy

NAC 306

“1. Every caregiver in a child care facility must: (a) Be at least 16 years of age; (b) Be able to summon help in an emergency; (c) Be emotionally and physically qualified to carry out a program which places emphasis on the development of children; and (d) Except as otherwise provided in subsection 5, within 90 days after the caregiver commences employment in the child care facility, apply with The Nevada Registry or its successor organization, and annually renew his or her registration before the date on which it expires. 2. Not more than 50 percent of the caregivers in a child care center, a child care institution or an early care and education program may be under 18 years of age. Any caregiver who is under 18 years of age and is employed in such a facility must: (a) Have completed a course in the development of children which is approved by: (1) The Nevada Registry or its successor organization, or any other agency designated by the Director of the Department to approve such courses; or (2) If the course has not been approved by The Nevada Registry or its successor organization, and the Director of the Department has not designated another agency to approve such courses, the Division or the local licensing agency; or (b) Be currently enrolled in such a course. 3. A child care facility may not be operated unless a person who is 18 years of age or older is on the premises of the facility. 4. A volunteer for a child care facility, regardless of his or her age, and a member of the staff of the facility who is under 18 years of age may not provide direct care to a child at the facility unless the care is provided under the supervision of an employee of the facility who is 18 years of age or older. 5. A caregiver in a child care institution is not required to initially apply with or annually renew his or her registration with The Nevada Registry or its successor organization. The facility failed to ensure within 90 days after each caregiver commences his employment in the child care facility; they have applied with the Nevada Registry or its successor organization, and/or annually renewed his registration before the date on which it expires. Provide verification the staff members as noted have submitted initial or renewal application.”

NAC 310

“1. Every member of the staff of a facility, including a volunteer, and each resident of the facility shall present to the director of the facility, to be placed in the person’s file, written evidence that the person is free from communicable tuberculosis. The evidence must be in the form of a report which states that the person is free from active tuberculosis as required pursuant to subsection 2 or 3. This subsection does not apply to a child who is receiving child care services from the facility or a child who resides at the facility who is not employed by or volunteering at the facility. 2. Before a person, including a person who has received a bacillus Calmette- Guerin (BCG) vaccination, begins employment, volunteering or residing at a facility, he or she must have submitted to a: (a) Tuberculin test; or (b) Chest radiograph and examination by a provider of health care who is authorized to diagnose active tuberculosis, Ê within the 12 months immediately preceding the first day of employment, volunteering or residing at the facility. 3. Every member of the staff of a facility, including a volunteer, and each resident of the facility shall submit to: (a) A tuberculin test; or (b) An examination by a provider of health care who is authorized to diagnose active tuberculosis, Ê at least once every 24 months after the date the tuberculin test or chest radiograph and examination were conducted pursuant to subsection 2. 4. Each caregiver or member of the staff of a facility who has an identified health problem that may affect his or her ability to provide adequate care to children in a facility shall: (a) Report the problem to the director of the facility or, if self-employed, to his or her licensing agency; and (b) Submit to the director or, if self- employed, to his or her licensing agency, a written statement from a licensed physician attesting to the fact that the health of the caregiver does not endanger the children who are under his or her care in the facility. 5. Each director shall report to his or her licensing agency any health problem reported to him or her pursuant to subsection 4. 6. Each director or caregiver, if self- employed, shall immediately report to his or her licensing agency any person residing at his or her facility who contracts a serious communicable disease. 7. Each caregiver or member of the staff of a facility who has herpetic gingivostomatitis, a cold sore or herpes labialis shall: (a) Refrain from engaging in close contact with children cared for in the facility; (b) Refrain from sharing food or drink with children cared for in the facility or with other caregivers or members of the staff of the facility; (c) Avoid touching the lesions; (d) Wash his or her hands frequently; and (e) Cover any skin lesion with a bandage, clothing or other appropriate dressing. Negative TB tests are needed for all caregivers. These staff may not return to work until a negative TB is provided to CCL.”

NAC 323

“1. Except as otherwise provided in NAC 432A.521 and NRS 432A.177, within 120 days after commencing his or her employment or position in a child care facility, each person who is employed in a child care facility, other than a person employed in a facility that provides care for ill children, and each director of a child care facility shall complete: (a) Any training required by the facility in which the director serves or in which the person is employed for the purposes of obtaining certification in the administration of cardiopulmonary resuscitation as required pursuant to NAC 432A.322; (b) Three or more hours of training in child development or guidance and discipline specific to the age group served by the facility in which the director serves or in which the person is employed; (c) Two or more hours of training in the administration of first aid; (d) Two or more hours of training in the recognition of signs and symptoms of illness, which must include, without limitation, training in the prevention of exposure to bloodborne pathogens; (e) Two or more hours of training in the recognition and reporting of child abuse and neglect; (f) If the person or director works with infants under 12 months of age, at least: (1) Two hours of training concerning Sudden Infant Death Syndrome; and (2) One hour of training in the prevention of shaken baby syndrome and abusive head trauma; (g) Two or more hours of training in the administration of medication, which must include, without limitation, training in the prevention of and response to food and other allergies; (h) Two or more hours of training in building and physical premises safety, which must include, without limitation, training in the storage of biocontaminants and other hazardous materials; (i) Two or more hours of training in emergency preparedness and response planning for emergencies resulting from a natural or man-made event; (j) If the facility provides transportation, 1 or more hours of training in precautions to be taken when transporting children for each person who will provide such transportation; and (k) Two or more hours of training in lifelong wellness, health and safety of children, which must include, without limitation, training relating to childhood obesity, nutrition and moderate or vigorous physical activity. 2. Except as otherwise provided in NAC 432A.521, within 12 months after commencing employment, each person described in subsection 1 shall, in addition to completing any training required pursuant to subsection 1 and completing any course in the development of children required pursuant to NAC 432A.306, complete at least the number of hours of training described in NAC 432A.326. A person may use training completed pursuant to subsection 1 to satisfy the training requirements set forth in NAC 432A.326. 3. Except as otherwise provided in NAC 432A.521, within 12 months after commencing employment as a member of the staff of a facility, each member of the staff of a facility shall complete a course in the development of children required pursuant to NAC 432A.306. 4. The training concerning the administration of first aid and the recognition of signs and symptoms of illness that is required to be completed pursuant to subsection 1 must be provided by one of the persons, agencies or institutions listed in NAC 432A.308 as qualified to provide such training. 5. The training required pursuant to subsections 1, 2 and 3 must be designed to: (a) Ensure the protection of the health and safety of each child enrolled in the facility; and (b) Promote the physical, moral and mental well-being of each child enrolled in the facility. 6. If the facility is a special needs facility, the training required pursuant to subsections 1, 2 and 3 must also be designed to provide information on the characteristics of handicapping conditions and appropriate programs for children with special needs. The training must be approved by: (a) The Nevada Registry or its successor organization, or any other agency designated by the Director of the Department to approve such training; or (b) If the training has not been approved by The Nevada Registry or its successor organization, and the Director of the Department has not designated another agency to approve such courses, the Division or the local licensing agency. 7. Evidence that an employee has completed the training required pursuant to subsections 1, 2 and 3 must be included in his or her personnel file and must be kept at the facility. With regard to training concerning the administration of first aid and the recognition of signs and symptoms of illness, the evidence listed in NAC 432A.308 as adequate evidence of compliance is adequate evidence of compliance for the purposes of this section. The facility failed to ensure that within 90 days of hire each employee completed the required hours of training in child care which includes: any training required by the facility for the purposes of obtaining certification in CPR, three or more hours of training in child development , two or more hours of training in first aid, two or more hours of training in the signs and symptoms of illness, which must include, without limitation, training in the prevention of exposure to bloodbourne pathogens, and two or more hours of training in the recognition and reporting of child abuse. In addition, if a person works with infants under 12 months of age, at least 2 hours of training concerning SIDS. Staff as listed on the supplement need to secure child care training.”

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.”

NAC 430.3

“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. 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.”

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.370

“1. Evidence of each child ' s health must be presented to the director of a facility, other than an accommodation facility or a facility that provides care for ill children, within 30 days after the child ' s initial admission. The evidence must include a written statement from a licensed physician or registered nurse attesting to the status of the child ' s health and stating that all known special conditions are under treatment and the child is capable of adjusting to the programs of the facility. 2. A licensee of each such facility shall keep a record of each child which includes any pertinent information on the status of the child ' s health and any special needs of the child.”

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.”

NAC 350

“1. Every licensee of a facility shall adopt a written statement which: (a) Sets forth the general services to be offered to the children; (b) Provides for the special needs of each child; (c) States the requirements for admission and procedures for enrollment; (d) Sets forth fees and any plan for payment of fees; (e) Provides rules relating to personal belongings brought to the facility; (f) Covers arrangements for transportation; (g) Requires written parental permission for trips and activities outside the facility; (h) Provides for parental involvement in the general functions of the facility; (i) Gives either or both parents the right to observe the program of the licensee before enrollment and at any time after enrollment of the child; (j) For a child care facility as defined in paragraph (a) of subsection 7 of NRS 202.2491 <../NRS/NRS-202.html>, notifies either or both parents that smoking of tobacco in any form is prohibited in the facility at all times; (k) For a facility other than a child care facility as defined in paragraph (a) of subsection 7 of NRS 202.2491 <../NRS/NRS-202.html>, notifies either or both parents if smoking of tobacco is permitted on the premises of the facility in a designated area approved by the fire authority; (l) Notifies either or both parents if and when a member of the staff who is trained and certified in cardiopulmonary resuscitation is on duty at the facility; and (m) Notifies either or both parents of the contents of any plan created pursuant to NAC 432A.280 to ensure that the staff of the facility is prepared to respond to an emergency. 2. In addition to the information required by subsection 1, a licensee for a facility that provides care for ill children shall adopt criteria for admission that set forth: (a) The illnesses and disabilities that are accepted; (b) The illnesses and disabilities that are not accepted; (c) The ages of children served by the facility; (d) The information required from a parent before a child may be admitted to the facility; and (e) The procedures to be followed by the staff of the facility in the event of an emergency. 3. Every licensee shall provide a copy of the statement described in subsection 1 to each paid or volunteer member of its staff, to each parent of a child enrolled in the facility and to the Health Division. 4. The name, business address and business telephone number of any person who has legal or administrative responsibility for the facility must be provided to each parent of a child enrolled in the facility and to the Health Division. 5. The licensee of a facility shall notify each parent of a child enrolled in the facility and the Health Division of significant changes in the services offered by the facility.”

NAC 200.3

“3. Documentation of completed and current investigations must be kept on file at the facility for all persons required to be investigated, for the period of their presence at the facility. Facility failed to ensure that the backgrounds Clearance Memo and Consent and Release Form were kept on file. Ensure both documents are kept on file at the facility for all staff and volunteers.”

NAC 200.6

“6. The license must not be issued until the Administrator of the Division is satisfied that the proposed facility will be in compliance with the applicable codes concerning safety of human life, environmental health, and building and zoning, as established respectively by the State Fire Marshal, the State Board of Health and the appropriate local government. A report of inspection by the State Fire Marshal or the Division, finding satisfactory conditions, may be accepted by the Administrator as proof of compliance with the applicable regulations.”

NAC 220

“1. Except as otherwise provided in NAC 432A.437, a licensee of a facility may apply for reissuance of a license by submitting an application for reissuance which must be received by the Division, or postmarked if mailed, not later than 45 days before the expiration of the license. The Division shall provide all forms and materials necessary for reissuance of a license. The Division shall charge a late fee of $50 for an application for reissuance of a license that is received or postmarked later than 30 days before the expiration of the license. 2. After receipt of an application for reissuance of a license and the receipt of a fee for reissuance computed in the same manner described in subsection 1 of NAC 432A.200, the Division shall conduct a survey to determine whether the licensee of a facility meets all of the requirements for issuance of a license set forth in NAC 432A.200. 3. If, after investigation, the Division determines that the facility complies with the requirements of NAC 432A.200, a license must be reissued for 1 year. A reissued license may be revoked or suspended on the same grounds as an initial license.”

NAC 265

“1. Each facility shall ensure that any immunizations recommended by a veterinarian for a pet kept at the facility are up-to-date, regardless of whether the pet is kept inside or outside the facility. 2. Pets are only permitted in a facility if they are: (a) In good health, present no problems of sanitation and have a temperament which is not hazardous or frightening to children; (b) Handled in a manner which protects the well-being of the children and the pet; (c) Inoculated as often as prescribed by a veterinarian; and (d) Restricted from areas where food is prepared and from eating areas while meals are being served as required by state and local health agencies. 3. Each facility shall ensure that any litter boxes are kept out of the reach of young children and that play areas are cleaned of all animal feces before children are allowed access to those areas. The facility failed to ensure any immunizations for a pet kept at the facility were up to date, and that the pet was inoculated as prescribed by a veterinarian. Provide verification pet(s) have been inoculated.”

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 280.3

“"3. The licensee of a facility shall hold: (a) A fire drill at least once every month; and (b) A drill for natural disasters at least once every 3 months." The facility had no record that a fire drill was held at least once every month. Hold fire drills as required and complete a record of the drills., The facility had no record that a drill for natural disasters was held at least once every three months. Hold drills for natural disasters as required and complete a record of the drills.”

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 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 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., Staff did not use a two-step procedure for cleaning and disinfecting nonporous surfaces such as toys, cribs, tables, etc. Ensure staff first clean with soap and water and then disinfect with a disinfecting agent.”

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 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.”

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 323

“1. Except as otherwise provided in NAC 432A.521 and NRS 432A.177, within 120 days after commencing his or her employment or position in a child care facility, each person who is employed in a child care facility, other than a person employed in a facility that provides care for ill children, and each director of a child care facility shall complete: (a) Any training required by the facility in which the director serves or in which the person is employed for the purposes of obtaining certification in the administration of cardiopulmonary resuscitation as required pursuant to NAC 432A.322; (b) Three or more hours of training in child development or guidance and discipline specific to the age group served by the facility in which the director serves or in which the person is employed; (c) Two or more hours of training in the administration of first aid; (d) Two or more hours of training in the recognition of signs and symptoms of illness, which must include, without limitation, training in the prevention of exposure to bloodborne pathogens; (e) Two or more hours of training in the recognition and reporting of child abuse and neglect; (f) If the person or director works with infants under 12 months of age, at least: (1) Two hours of training concerning Sudden Infant Death Syndrome; and (2) One hour of training in the prevention of shaken baby syndrome and abusive head trauma; (g) Two or more hours of training in the administration of medication, which must include, without limitation, training in the prevention of and response to food and other allergies; (h) Two or more hours of training in building and physical premises safety, which must include, without limitation, training in the storage of biocontaminants and other hazardous materials; (i) Two or more hours of training in emergency preparedness and response planning for emergencies resulting from a natural or man-made event; (j) If the facility provides transportation, 1 or more hours of training in precautions to be taken when transporting children for each person who will provide such transportation; and (k) Two or more hours of training in lifelong wellness, health and safety of children, which must include, without limitation, training relating to childhood obesity, nutrition and moderate or vigorous physical activity. 2. Except as otherwise provided in NAC 432A.521, within 12 months after commencing employment, each person described in subsection 1 shall, in addition to completing any training required pursuant to subsection 1 and completing any course in the development of children required pursuant to NAC 432A.306, complete at least the number of hours of training described in NAC 432A.326. A person may use training completed pursuant to subsection 1 to satisfy the training requirements set forth in NAC 432A.326. 3. Except as otherwise provided in NAC 432A.521, within 12 months after commencing employment as a member of the staff of a facility, each member of the staff of a facility shall complete a course in the development of children required pursuant to NAC 432A.306. 4. The training concerning the administration of first aid and the recognition of signs and symptoms of illness that is required to be completed pursuant to subsection 1 must be provided by one of the persons, agencies or institutions listed in NAC 432A.308 as qualified to provide such training. 5. The training required pursuant to subsections 1, 2 and 3 must be designed to: (a) Ensure the protection of the health and safety of each child enrolled in the facility; and (b) Promote the physical, moral and mental well-being of each child enrolled in the facility. 6. If the facility is a special needs facility, the training required pursuant to subsections 1, 2 and 3 must also be designed to provide information on the characteristics of handicapping conditions and appropriate programs for children with special needs. The training must be approved by: (a) The Nevada Registry or its successor organization, or any other agency designated by the Director of the Department to approve such training; or (b) If the training has not been approved by The Nevada Registry or its successor organization, and the Director of the Department has not designated another agency to approve such courses, the Division or the local licensing agency. 7. Evidence that an employee has completed the training required pursuant to subsections 1, 2 and 3 must be included in his or her personnel file and must be kept at the facility. With regard to training concerning the administration of first aid and the recognition of signs and symptoms of illness, the evidence listed in NAC 432A.308 as adequate evidence of compliance is adequate evidence of compliance for the purposes of this section. The facility failed to ensure that within 90 days of hire each employee completed the required hours of training in child care which includes: any training required by the facility for the purposes of obtaining certification in CPR, three or more hours of training in child development , two or more hours of training in first aid, two or more hours of training in the signs and symptoms of illness, which must include, without limitation, training in the prevention of exposure to bloodbourne pathogens, and two or more hours of training in the recognition and reporting of child abuse. In addition, if a person works with infants under 12 months of age, at least 2 hours of training concerning SIDS. Staff as listed on the supplement need to secure child care training.”

NAC 308

“1. Whenever a child care facility is in operation, each caregiver on duty must have completed training for the recognition of signs and symptoms of illness and the administration of first aid. 2. The training for the recognition of signs and symptoms of illness must include, without limitation, the provision of information concerning health and the observation and evaluation of signs and symptoms of illness and responses to illness and emergencies and training in the prevention of exposure to bloodborne pathogens. The training for the administration of first aid must include, without limitation, the administration of first aid to victims of fire, serious injury or the ingestion of poison. Both types of training must be: (a) Provided by a licensed health care professional or a representative of a licensed health care agency or clinic, a community college, a university, the American National Red Cross, an adult education program in home nursing or an institution approved by The Nevada Registry or its successor organization; and (b) Approved by: (1) The Nevada Registry or its successor organization, or any other agency designated by the Director of the Department to approve the training; or (2) If the training is not approved by The Nevada Registry or its successor organization, and the Director of the Department has not designated another agency to approve the training, the Division or the local licensing agency. 3. A certificate or other evidence of compliance issued by a licensed health care professional, a licensed health care agency or clinic, a community college, a university, the American National Red Cross, an adult education program in home nursing or an approved provider of such training is adequate evidence of compliance. Documentation for training did not show that the trainer was qualified to provide the training. Obtain verification the trainer meets the requirements: or if this is not possible, new training must be completed”

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 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 220

“1. Except as otherwise provided in NAC 432A.437, a licensee of a facility may apply for reissuance of a license by submitting an application for reissuance which must be received by the Division, or postmarked if mailed, not later than 45 days before the expiration of the license. The Division shall provide all forms and materials necessary for reissuance of a license. The Division shall charge a late fee of $50 for an application for reissuance of a license that is received or postmarked later than 30 days before the expiration of the license. 2. After receipt of an application for reissuance of a license and the receipt of a fee for reissuance computed in the same manner described in subsection 1 of NAC 432A.200, the Division shall conduct a survey to determine whether the licensee of a facility meets all of the requirements for issuance of a license set forth in NAC 432A.200. 3. If, after investigation, the Division determines that the facility complies with the requirements of NAC 432A.200, a license must be reissued for 1 year. A reissued license may be revoked or suspended on the same grounds as an initial license.”

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 facility failed to have a complete admission packet for the below listed child. Ensure that information provided by the parent before admission includes the name, address and telephone number of each parent and any special instructions needed to reach the parent during the hours the child is in the facility. Ensure that information provided by the parent before admission includes 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. Secure missing information for the child(ren) as noted on the supplement., 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 information concerning the health of the child, including any special needs of the child. Secure missing health information for the child(ren) as noted on the supplement.”

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. 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. 2. If required by the director or owner of the facility, a member of the staff of a facility shall participate in any specialized training related to child care which is offered in the community where the facility is located. 3. A volunteer who works at least 15 hours per week in a facility and participates in specialized child care training, as defined by the director: (a) Is a member of the staff of the facility for the purposes of this section; and (b) Must satisfy the training and certification requirements set forth in NAC 432A.323 and 432A.326. 4. Any training received by an employee of a facility or a volunteer who works in a facility as part of the orientation required by this section may not be applied toward meeting the training requirements set forth in NAC 432A.323 and 432A.326.”

NAC 310

“1. Every member of the staff of a facility, including a volunteer, and each resident of the facility shall present to the director of the facility, to be placed in the person’s file, written evidence that the person is free from communicable tuberculosis. The evidence must be in the form of a report which states that the person is free from active tuberculosis as required pursuant to subsection 2 or 3. This subsection does not apply to a child who is receiving child care services from the facility or a child who resides at the facility who is not employed by or volunteering at the facility. 2. Before a person, including a person who has received a bacillus Calmette- Guerin (BCG) vaccination, begins employment, volunteering or residing at a facility, he or she must have submitted to a: (a) Tuberculin test; or (b) Chest radiograph and examination by a provider of health care who is authorized to diagnose active tuberculosis, Ê within the 12 months immediately preceding the first day of employment, volunteering or residing at the facility. 3. Every member of the staff of a facility, including a volunteer, and each resident of the facility shall submit to: (a) A tuberculin test; or (b) An examination by a provider of health care who is authorized to diagnose active tuberculosis, Ê at least once every 24 months after the date the tuberculin test or chest radiograph and examination were conducted pursuant to subsection 2. 4. Each caregiver or member of the staff of a facility who has an identified health problem that may affect his or her ability to provide adequate care to children in a facility shall: (a) Report the problem to the director of the facility or, if self-employed, to his or her licensing agency; and (b) Submit to the director or, if self- employed, to his or her licensing agency, a written statement from a licensed physician attesting to the fact that the health of the caregiver does not endanger the children who are under his or her care in the facility. 5. Each director shall report to his or her licensing agency any health problem reported to him or her pursuant to subsection 4. 6. Each director or caregiver, if self- employed, shall immediately report to his or her licensing agency any person residing at his or her facility who contracts a serious communicable disease. 7. Each caregiver or member of the staff of a facility who has herpetic gingivostomatitis, a cold sore or herpes labialis shall: (a) Refrain from engaging in close contact with children cared for in the facility; (b) Refrain from sharing food or drink with children cared for in the facility or with other caregivers or members of the staff of the facility; (c) Avoid touching the lesions; (d) Wash his or her hands frequently; and (e) Cover any skin lesion with a bandage, clothing or other appropriate dressing. Negative TB tests are needed for all caregivers. These staff may not return to work until a negative TB is provided to CCL.”

NAC 416

“1. Each member of the staff of a facility that is necessary to meet the applicable requirement for the ratio of caregivers to children set forth in NAC 432A.526 for napping or sleeping children must be on the same floor in the same building where the children are napping or sleeping. Members of the staff of each facility must be readily accessible and available to be summoned to ensure the safety of the children in the facility. 2. Areas provided for napping or sleeping in a facility must be sufficiently lighted to provide for visual supervision of the children at all times. 3. The staff of each facility shall: (a) Ensure that each infant under 12 months of age is placed on his or her back on a firm mattress, mat or pad manufactured for use by an infant when the infant is napping or sleeping; (b) Use a safe, sturdy, well-constructed, single-level, free-standing crib, portable crib or playpen for children to nap or sleep in; (c) Equip any such sleeping device with a waterproof, firm-fitting mattress; (d) Ensure that each crib to be used by a child who is 6 months of age or younger is constructed with vertical slats that are not more than 2 3/8 inches apart; (e) Ensure that a child who is 18 months of age or younger naps or sleeps in a crib which is appropriate for his or her age or in another sleeping device which has been approved by the Health Division; (f) Ensure that a child who is older than 18 months of age naps or sleeps in an appropriate crib or on a cot or mat; (g) Ensure that each sleeping device has appropriate bedding and a waterproof and washable covering; (h) Wipe clean each sleeping device with a disinfectant not less than one time each week or more often if necessary; (i) Ensure that the bedding that each child uses is used only for that particular child; (j) Replace the bedding each time it is wet or soiled by a child or when the sleeping device is to be used by another child; (k) Within 15 minutes after a child in a crib has awakened from a nap or from sleeping, take the child out of the crib and engage him or her in an appropriate activity; (l) Ensure that each child takes a nap as needed; (m) Ensure that each napping or sleeping child is in an area from which the staff can readily hear and see the child; and (n) Ensure that each napping or sleeping child is checked by a caregiver not less than one time every 15 minutes. 4. The staff of a facility shall not change the diaper of a child in a crib or other sleeping device. 5. The staff of a facility shall not use a waterbed, sofa, soft mattress, pillow or any other soft surface as a surface on which to place an infant under 12 months of age to nap or sleep. Based on”

NAC 412

“1. Each facility must have written procedures concerning the washing of hands. 2. The staff of a facility shall follow the procedures of the facility concerning the washing of hands and shall instruct, monitor and assist the children being cared for at the facility to ensure that the children follow the procedures. 3. The procedures concerning the washing of hands must require, without limitation, that: (a) The staff of the facility wash their hands with soap from a dispenser and warm water: (1) Any time that their hands come into contact with blood, mucus, vomit, feces or urine; (2) Before preparing or handling food; (3) Before engaging in any activity related to serving food, including, without limitation, setting the table; (4) Before and after eating a meal or snack; (5) After using the toilet, helping a child use the toilet or changing a diaper with or without gloves; (6) After attending to an ill child; (7) After handling an animal; (8) Before and after giving medication to a child; and (9) After cleaning a container used to store garbage or handling garbage. (b) The children being cared for in the facility wash their hands with soap from a dispenser and warm water: (1) Any time that their hands come into contact with blood, mucus, vomit, feces or urine; (2) Before handling food; (3) Before and after eating a meal or snack; (4) After handling an animal; (5) After the diaper or underwear of the child is changed; (6) After playing in water; and (7) After playing in a sandbox. (c) The staff of the facility shall ensure that: (1) Each bathroom has running water, soap and single-use or disposable towels; and (2) Any common basin or sink which is filled with standing water is not used for the washing of hands. The staff failed to instruct/monitor and assist children with hand washing. Staff must ensure children follow hand washing procedures., Staff failed to wash their hands with soap from a dispenser and warm water after coming in contact with diaper changes. Ensure staff members are made aware of required hand washing procedures., Based on”

NAC 411

“1. Each area in a facility that is used for changing diapers must: (a) Have a smooth, nonabrasive, impervious surface; (b) Be located within close proximity to a sink that is not used for the preparation of food; (c) Not be located in an area in which food is prepared; (d) Have a smooth, nonabsorbent floor covering; (e) Have nearby, for wet or soiled diapers, a washable receptacle that is lined with plastic and covered with a lid; (f) Be kept in good repair and in a safe condition; and (g) Be cleaned and disinfected after each use by removing any visible soil and applying an approved disinfectant. 2. Each soiled cloth diaper and any soiled clothing that may be contaminated with contagious matter must be stored in an individual plastic bag and be returned to the parents daily. The facility is not required to rinse or dump the contents of a diaper or the underwear of a child cared for in the facility. Each diaper used, including, without limitation, a commercial disposable diaper, must be able to contain urine and stool and minimize contamination. If cloth diapers are used on children, an absorbent inner liner and a waterproof outer covering must be provided with the diaper. 3. The staff of a facility: (a) Shall discourage children from coming near an area that is used for changing diapers; and (b) Shall not leave a child unattended in the diaper changing area. An area used for changing diapers failed to have a smooth, nonabrasive, impervious surface. Replace this changing surface with one that meets sanitation requirements.”

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.”

NAC.370

“1. Evidence of each child ' s health must be presented to the director of a facility, other than an accommodation facility or a facility that provides care for ill children, within 30 days after the child ' s initial admission. The evidence must include a written statement from a licensed physician or registered nurse attesting to the status of the child ' s health and stating that all known special conditions are under treatment and the child is capable of adjusting to the programs of the facility. 2. A licensee of each such facility shall keep a record of each child which includes any pertinent information on the status of the child ' s health and any special needs of the child.”

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:”

NAC 265

“1. Each facility shall ensure that any immunizations recommended by a veterinarian for a pet kept at the facility are up-to-date, regardless of whether the pet is kept inside or outside the facility. 2. Pets are only permitted in a facility if they are: (a) In good health, present no problems of sanitation and have a temperament which is not hazardous or frightening to children; (b) Handled in a manner which protects the well-being of the children and the pet; (c) Inoculated as often as prescribed by a veterinarian; and (d) Restricted from areas where food is prepared and from eating areas while meals are being served as required by state and local health agencies. 3. Each facility shall ensure that any litter boxes are kept out of the reach of young children and that play areas are cleaned of all animal feces before children are allowed access to those areas. The facility failed to ensure any immunizations for a pet kept at the facility were up to date, and that the pet was inoculated as prescribed by a veterinarian. Provide verification pet(s) have been inoculated., Based on file”

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.”

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 255

“1. Each facility shall ensure that weapons, including, without limitation, firearms, air rifles, bows, hunting knives or hunting slingshots, are not transported in any vehicle of the facility in which children are riding unless the weapons are made inoperable and inaccessible. 2. A licensee of a family home or group home shall ensure that any weapons in the facility are unstrung and unloaded at all times when children are in the facility. 3. A licensee of a family home or group home shall ensure that any weapons in the facility are either stored in locked containers or rooms that are out of the reach of children or are made inoperable. 4. A licensee of a family home or group home shall ensure that any ammunition and arrows in the facility are stored in separate locked containers. 5. Except as otherwise provided in this subsection and NRS 202.3673 , weapons are prohibited in any child care center, child care institution or facility for special events. The provisions of this subsection do not apply to a weapon carried by a peace officer or other law enforcement personnel certified by the Peace Officers ' Standards and Training Commission pursuant to NRS 289.550”

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).”

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).”

NAC 430.3

“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.”

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 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.”

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.”

NAC 306

“1. Every caregiver in a child care facility must: (a) Be at least 16 years of age; (b) Be able to summon help in an emergency; (c) Be emotionally and physically qualified to carry out a program which places emphasis on the development of children; and (d) Except as otherwise provided in subsection 5, within 90 days after the caregiver commences employment in the child care facility, apply with The Nevada Registry or its successor organization, and annually renew his or her registration before the date on which it expires. 2. Not more than 50 percent of the caregivers in a child care center, a child care institution or an early care and education program may be under 18 years of age. Any caregiver who is under 18 years of age and is employed in such a facility must: (a) Have completed a course in the development of children which is approved by: (1) The Nevada Registry or its successor organization, or any other agency designated by the Director of the Department to approve such courses; or (2) If the course has not been approved by The Nevada Registry or its successor organization, and the Director of the Department has not designated another agency to approve such courses, the Division or the local licensing agency; or (b) Be currently enrolled in such a course. 3. A child care facility may not be operated unless a person who is 18 years of age or older is on the premises of the facility. 4. A volunteer for a child care facility, regardless of his or her age, and a member of the staff of the facility who is under 18 years of age may not provide direct care to a child at the facility unless the care is provided under the supervision of an employee of the facility who is 18 years of age or older. 5. A caregiver in a child care institution is not required to initially apply with or annually renew his or her registration with The Nevada Registry or its successor organization.”

NAC 280.6

“6. To maintain his or her license, the licensee must ensure that his or her facility meets all standards for fire safety which are established by the State Fire Marshal.”

NAC 280.3

“"3. The licensee of a facility shall hold: (a) A fire drill at least once every month; and (b) A drill for natural disasters at least once every 3 months."”

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.”

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. A certificate of immunization prerequisite to admission to child care facility; Child(ren) as noted below failed to have current immunization records on file at time of inspection.”

NAC.370

“1. Evidence of each child ' s health must be presented to the director of a facility, other than an accommodation facility or a facility that provides care for ill children, within 30 days after the child ' s initial admission. The evidence must include a written statement from a licensed physician or registered nurse attesting to the status of the child ' s health and stating that all known special conditions are under treatment and the child is capable of adjusting to the programs of the facility. 2. A licensee of each such facility shall keep a record of each child which includes any pertinent information on the status of the child ' s health and any special needs of the child.”

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. Fingerprints were not taken and a release form was not completed by a caregiver at the facility who is at least 18 years of age or a volunteer who is at least 18 years of age within 24 hours after the date of hire or his presence in the facility. Have the caregiver secure required fingerprints and submit with a release form.”