Super Genius Kids

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 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 374

“1. If a child becomes seriously ill or injured in a child care facility, other than a facility that provides care for ill children: (a) The child must be immediately isolated from other children and placed under appropriate supervision; (b) A parent, a person designated by a parent or a physician designated by a parent must be promptly notified and the child must be removed from the facility as quickly as possible; (c) Members of the staff of the facility must not administer any medical treatment, except emergency first aid and prescribed medications to the child; and (d) Not later than 24 hours after the occurrence of the illness or injury, a member of the staff of the facility must create a written report concerning the illness or injury. The written report must be placed in the file concerning the child that is maintained by the facility, and a copy of the written report must be provided to a parent of the child. Upon request by the Division, the facility must provide to the Division the written report and any statements by members of the staff of the facility that are part of the written report. 2. If a member of the staff transports or accompanies a child for professional emergency care, he or she shall remain with the child until the parents assume responsibility for the care of the child. Based on staff”

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

“1. Except as otherwise provided in this subsection, subsection 3 and NRS 432A.078 in each facility there must be: (a) At least 35 square feet of indoor space for each child, exclusive of bathrooms, halls, kitchen, stairs, storage spaces, multipurpose rooms and gymnasiums that are not regularly used. (b) At least 37 1/2 square feet of outdoor play space for each child, as determined by the maximum number of children stated on the license for the facility. An accommodation facility need not provide outdoor play space. 2. Each facility shall: (a) Ensure that each room of the facility which is used by children is: (1) Maintained free of drafts and at a temperature that is not less than 65 degrees Fahrenheit and not more than 82 degrees Fahrenheit during the months of October through March and at a temperature that is not less than 68 degrees Fahrenheit and not more than 82 degrees Fahrenheit during the months of April through September; and (2) Heated, cooled and ventilated to maintain the temperatures required in this paragraph and to avoid the accumulation of odors and fumes; (b) Ensure that electrical devices or electrical apparatuses which are accessible to children are not located near any type of water source, including, without limitation, any sink, tub, shower area or wading pool; and (c) Install nonflammable barriers, including, without limitation, permanent guards or shields to cover heating units, including, without limitation, hot water heating pipes and baseboard heaters with a surface temperature that is hotter than 100 degrees Fahrenheit, to ensure that those heating units are inaccessible to children. 3. A facility that provides care for ill children must have: (a) At least 50 square feet of indoor space for each child, as determined by the maximum number of children stated on the license for the facility, exclusive of bathrooms, halls, kitchen, stairs and storage spaces. (b) A separate ventilation system if the facility is attached to another building. 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. 5. If a facility that provides care for ill children is a component of a child care center and provides outdoor play space, the play space must: (a) Be separate from the play space for well children; (b) Meet the requirements of paragraph (b) of subsection 1; and (c) Meet the requirements of subsection 4. REVISER ' S NOTE. The regulation of the Board for Child Care filed with the Secretary of State on April 23, 2009 (LCB File No. R032-07), which amended this section, contains the following provision not included in NAC: " 1. A child care facility is exempt from the provisions of paragraph (e) of subsection 4 of NAC 432A.250, as amended by section 9 of this regulation, until the date for compliance with those provisions established by the Bureau of Services for Child Care of the Division of Child and Family Services of the Department of Health and Human Services [now the Division] or an agency for the licensing of child care facilities established by a county or city, as applicable. 2. As used in this section, " child care facility " has the meaning ascribed to it in NAC 432A.060. "”

NAC 290

“1. Each licensee of a facility shall have a working telephone listed in a local telephone directory. A current list of emergency telephone numbers, including health agencies, fire and police departments and ambulance services must be posted adjacent to the telephone. 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. 3. If transportation is provided by the licensee of a facility, all children must be protected by adequate supervision by the staff, safety precautions and adequate insurance which covers liability for health or injury, medical expenses and damages caused by uninsured motorists. The licensee of a facility shall require that each child is instructed in the conduct required for safe transportation. A driver of a vehicle used by the licensee of a facility shall: (a) Possess an appropriate driver ' s license and adequate insurance; (b) Not leave an unattended child in the vehicle at any time; (c) Ensure that a parent, or a person designated in writing by the parent, is present to take charge of a child upon delivery of the child to his or her home or the facility; (d) Ensure that each child boards or departs the vehicle on the side of the vehicle adjacent to a curb and that the child is safely conducted across any street encountered immediately before boarding or after departing; and (e) Ensure that the doors and windows of the vehicle are secure before proceeding. 4. Except as otherwise provided in this section and NAC 432A.532, when transporting children, the licensee of a facility shall ensure that the ratio of caregivers to children in the vehicle satisfies the applicable requirement for the ratio of caregivers to children set forth in NAC 432A.524. When transporting children who are 2 years of age or older, a licensee of a special needs facility shall ensure that the ratio of caregivers to children in the vehicle satisfies the applicable requirement for the ratio of caregivers to children set forth in NAC 432A.532. 5. If, during the time school is in operation, the licensee of a facility provides transportation for children of school age to and from a public or private school, the ratio of staff to children in the vehicle must be not less than one member of the staff for every 15 children. 6. The licensee of a facility shall maintain a log for transportation provided by the licensee of the facility. The log must be maintained at the facility for at least 4 months after the transportation is provided. The log must include: (a) The name of each child who was transported; (b) The date the transportation was provided by the licensee of the facility; (c) The time of departure of the vehicle and the time the vehicle arrived at its destination; (d) The signature of the driver of the vehicle; (e) The name of each adult who was transported in the vehicle, including, without limitation, the driver of the vehicle; and (f) The signed verification required by subsection 7. 7. Upon arrival at the destination, one member of the staff of the facility shall mark each child off the log as the child departs the vehicle, conduct a physical inspection and visually and physically sweep the vehicle to ensure a child is not left behind in the vehicle, and include in the log signed verification that each child who was transported in the vehicle is accounted for and that the visual and physical sweeps were conducted.”

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.”

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 520

“1. A licensee of a child care facility shall have a staff which is sufficient in number to provide physical care, supervision and individual attention to each child and allow time for interaction between the staff and the children to promote the children ' s social competence, emotional well-being and intellectual development. 2. Except as otherwise provided in subsection 3, in addition to the number of caregivers that are required to satisfy the applicable ratio of caregivers to children set forth in NAC 432A.524, one additional caregiver or an adult volunteer per each group of children must be present on all field trips away from the child care facility to assist in providing direct supervision to the children and to increase the safety of the children. 3. The provisions of subsection 2 do not apply: (a) If the purpose for leaving the child care facility is to transport the children from the child care facility to another location and, upon reaching that location, the responsibility for caring for the children is assumed by another adult. (b) To a group of children that is composed entirely of children of school age, including children who are attending kindergarten. 4. A member of the staff of a facility who is supervising a child pursuant to subsection 1 must: (a) Be physically present in the room where the child being supervised is present; (b) Observe, oversee and guide the child; (c) Be aware of the needs of the child and accountable for the care of the child; and (d) Maintain a proximity to the child that allows the member of the staff to be capable of intervening if assistance or direction is needed by the child. The facility failed to have staff present which is sufficient in number to provide physical care, supervision and individual attention to each child and allow time for interaction between the staff and the children to promote the children ' s social competence, emotional well-being and intellectual development.”

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. 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., Certificate of”

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 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 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 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., Based on interview”

NAC 304

“1. The director of a child care facility is responsible for screening, scheduling and supervising the staff of the facility and for the conduct of each member of the staff at the facility. 2. The director shall: (a) Provide a program for child care for the facility which meets the requirements of this chapter. (b) Be physically present in the facility for a sufficient amount of time to ensure compliance with the provisions of this chapter and chapter 432A of NRS. (c) Provide space for an office, the storage of records, conferences with parents, meetings of the staff and all other needs of the program for child care. (d) Maintain organized separate records for each employee that include, without limitation, documents related to training. Such records must include, without limitation: (1) Documents verifying that the employee has, if applicable: (I) Completed the training required pursuant to NRS 432A.177; (II) Received the orientation and basic training required pursuant to NAC 432A.320; (III) Completed the training required pursuant to NAC 432A.323; and (IV) Completed the training required pursuant to NAC 432A.326; and (2) A copy of the documentation concerning, and the results of, the investigation of the employee’s background and personal history which is conducted pursuant to NRS 432A.170, including, without limitation, a clearance letter from the Division or a current child care work card, and a release form for this information completed by the employee. (e) Ensure that each member of the staff of the facility who is not a caregiver, but whose job duties may directly impact children cared for in the facility, has the training necessary to protect the health and safety of the children and the health and safety of the other members of the staff, including, without limitation, training concerning proper nutrition, methods of sanitation and procedures for maintaining a safe environment in the facility. (f) Work with parents and include them, whenever possible, in the programming and functioning of activities. (g) Cooperate with the Division and other agencies of government to improve the quality of child care and the competence of caregivers. (h) Designate a member of the staff who is responsible for the operation of the facility when the director is not present at the facility. 3. If the facility is in operation 25 hours or less per week, the director must be present in the facility during at least half the hours of operation.”

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 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.”

NAC 250

“1. Except as otherwise provided in this subsection, subsection 3 and NRS 432A.078 in each facility there must be: (a) At least 35 square feet of indoor space for each child, exclusive of bathrooms, halls, kitchen, stairs, storage spaces, multipurpose rooms and gymnasiums that are not regularly used. (b) At least 37 1/2 square feet of outdoor play space for each child, as determined by the maximum number of children stated on the license for the facility. An accommodation facility need not provide outdoor play space. 2. Each facility shall: (a) Ensure that each room of the facility which is used by children is: (1) Maintained free of drafts and at a temperature that is not less than 65 degrees Fahrenheit and not more than 82 degrees Fahrenheit during the months of October through March and at a temperature that is not less than 68 degrees Fahrenheit and not more than 82 degrees Fahrenheit during the months of April through September; and (2) Heated, cooled and ventilated to maintain the temperatures required in this paragraph and to avoid the accumulation of odors and fumes; (b) Ensure that electrical devices or electrical apparatuses which are accessible to children are not located near any type of water source, including, without limitation, any sink, tub, shower area or wading pool; and (c) Install nonflammable barriers, including, without limitation, permanent guards or shields to cover heating units, including, without limitation, hot water heating pipes and baseboard heaters with a surface temperature that is hotter than 100 degrees Fahrenheit, to ensure that those heating units are inaccessible to children. 3. A facility that provides care for ill children must have: (a) At least 50 square feet of indoor space for each child, as determined by the maximum number of children stated on the license for the facility, exclusive of bathrooms, halls, kitchen, stairs and storage spaces. (b) A separate ventilation system if the facility is attached to another building. 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. 5. If a facility that provides care for ill children is a component of a child care center and provides outdoor play space, the play space must: (a) Be separate from the play space for well children; (b) Meet the requirements of paragraph (b) of subsection 1; and (c) Meet the requirements of subsection 4. REVISER ' S NOTE. The regulation of the Board for Child Care filed with the Secretary of State on April 23, 2009 (LCB File No. R032-07), which amended this section, contains the following provision not included in NAC: " 1. A child care facility is exempt from the provisions of paragraph (e) of subsection 4 of NAC 432A.250, as amended by section 9 of this regulation, until the date for compliance with those provisions established by the Bureau of Services for Child Care of the Division of Child and Family Services of the Department of Health and Human Services [now the Division] or an agency for the licensing of child care facilities established by a county or city, as applicable. 2. As used in this section, " child care facility " has the meaning ascribed to it in NAC 432A.060. "”

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. Documentation of completed and current investigations were not on file at the facility for required persons. The following items were not observed for individuals as noted below:”

NRS 170.6

“NRS432A.170.6 A person who is required to submit an investigation required pursuant to this section shall not have contact with a child in a child care facility without supervision before the investigation of the background and personal history of the person has been conducted.”

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.”

NAC 5205

“1. Except as otherwise provided in NAC 432A.290 and 432A.546, a licensee of a child care center, child care institution, accommodation facility, facility for special events, nursery for infants and toddlers or special needs facility shall, between the hours of 6:30 a.m. and 9:00 p.m., abide by the following staffing levels in each classroom: Age of Child Required Staff to Child Ratio Group Size Less than 9 months of age 1 caregiver for every 4 children 8 9 months of age or older but less than 2 years of age 1 caregiver for every 6 children 12 2 years of age or older but less than 3 years of age 1 caregiver for every 9 children 18 3 years of age or older but less than 4 years of age 1 caregiver for every 12 children 24 4 years of age or older but less than 5 years of age 1 caregiver for every 13 children 26 5 years of age or older 1 caregiver for every 18 children 36 2. Except as otherwise provided in NAC 432A.546, a licensee of a child care center, child care institution, accommodation facility, facility for special events, nursery for infants and toddlers or special needs facility which is operated between the hours of 9:00 p.m. and 6:30 a.m. shall abide by the following staffing levels in each classroom: Age of Child Required Staff to Child Ratio Group Size Less than 3 years of age 1 caregiver for every 6 children 12 3 years of age or older 1 caregiver for every 10 children 20 3. Every member of the staff of a child care center, child care institution, accommodation facility, facility for special events, nursery for infants and toddlers or special needs facility who is on duty at night shall remain awake during duty hours. 4. A licensee of a child care facility is allowed to utilize all useable and measured square footage within a classroom to meet the requirements of NAC 432A.250 if the requirements for ratios and groups described in subsections 1 and 2 are maintained within such classrooms. 5. If a licensee of a child care facility care for children of different age groups as described in subsections 1 and 2, the licensee shall abide by the required staff to child ratio and group size based on the age of the youngest child in the group. The facility failed to provide an adequate # of staff for the number of infants/toddlers in care. Take corrective action to ensure sufficient staffing in order to provide for children ' s needs.”

NAC 520

“1. A licensee of a child care facility shall have a staff which is sufficient in number to provide physical care, supervision and individual attention to each child and allow time for interaction between the staff and the children to promote the children ' s social competence, emotional well-being and intellectual development. 2. Except as otherwise provided in subsection 3, in addition to the number of caregivers that are required to satisfy the applicable ratio of caregivers to children set forth in NAC 432A.524, one additional caregiver or an adult volunteer per each group of children must be present on all field trips away from the child care facility to assist in providing direct supervision to the children and to increase the safety of the children. 3. The provisions of subsection 2 do not apply: (a) If the purpose for leaving the child care facility is to transport the children from the child care facility to another location and, upon reaching that location, the responsibility for caring for the children is assumed by another adult. (b) To a group of children that is composed entirely of children of school age, including children who are attending kindergarten. 4. A member of the staff of a facility who is supervising a child pursuant to subsection 1 must: (a) Be physically present in the room where the child being supervised is present; (b) Observe, oversee and guide the child; (c) Be aware of the needs of the child and accountable for the care of the child; and (d) Maintain a proximity to the child that allows the member of the staff to be capable of intervening if assistance or direction is needed by the child. The facility failed to have staff present which is sufficient in number to provide physical care, supervision and individual attention to each child and allow time for interaction between the staff and the children to promote the children ' s social competence, emotional well-being and intellectual development.”

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. Staff failed to ensure a child who is older than 18 months of age naps or sleeps in an appropriate crib or on a cot or mat.”

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 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 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.”

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 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 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 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 304

“1. The director of a child care facility is responsible for screening, scheduling and supervising the staff of the facility and for the conduct of each member of the staff at the facility. 2. The director shall: (a) Provide a program for child care for the facility which meets the requirements of this chapter. (b) Be physically present in the facility for a sufficient amount of time to ensure compliance with the provisions of this chapter and chapter 432A of NRS. (c) Provide space for an office, the storage of records, conferences with parents, meetings of the staff and all other needs of the program for child care. (d) Maintain organized separate records for each employee that include, without limitation, documents related to training. Such records must include, without limitation: (1) Documents verifying that the employee has, if applicable: (I) Completed the training required pursuant to NRS 432A.177; (II) Received the orientation and basic training required pursuant to NAC 432A.320; (III) Completed the training required pursuant to NAC 432A.323; and (IV) Completed the training required pursuant to NAC 432A.326; and (2) A copy of the documentation concerning, and the results of, the investigation of the employee’s background and personal history which is conducted pursuant to NRS 432A.170, including, without limitation, a clearance letter from the Division or a current child care work card, and a release form for this information completed by the employee. (e) Ensure that each member of the staff of the facility who is not a caregiver, but whose job duties may directly impact children cared for in the facility, has the training necessary to protect the health and safety of the children and the health and safety of the other members of the staff, including, without limitation, training concerning proper nutrition, methods of sanitation and procedures for maintaining a safe environment in the facility. (f) Work with parents and include them, whenever possible, in the programming and functioning of activities. (g) Cooperate with the Division and other agencies of government to improve the quality of child care and the competence of caregivers. (h) Designate a member of the staff who is responsible for the operation of the facility when the director is not present at the facility. 3. If the facility is in operation 25 hours or less per week, the director must be present in the facility during at least half the hours of operation. The director failed to maintain organized, separate records for each employee that include, without limitation , documents related to training and background investigations. Maintain employee records as required.”

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.”

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 200.3

“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. Documentation of completed and current investigations were not on file at the facility for required persons. The following items were not observed for individuals as noted below:”

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 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 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. 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 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.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.”

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 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 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. Staff failed to ensure a child who is older than 18 months of age naps or sleeps in an appropriate crib or on a cot or mat.”

NAC 5205

“1. Except as otherwise provided in NAC 432A.290 and 432A.546, a licensee of a child care center, child care institution, accommodation facility, facility for special events, nursery for infants and toddlers or special needs facility shall, between the hours of 6:30 a.m. and 9:00 p.m., abide by the following staffing levels in each classroom: Age of Child Required Staff to Child Ratio Group Size Less than 9 months of age 1 caregiver for every 4 children 8 9 months of age or older but less than 2 years of age 1 caregiver for every 6 children 12 2 years of age or older but less than 3 years of age 1 caregiver for every 9 children 18 3 years of age or older but less than 4 years of age 1 caregiver for every 12 children 24 4 years of age or older but less than 5 years of age 1 caregiver for every 13 children 26 5 years of age or older 1 caregiver for every 18 children 36 2. Except as otherwise provided in NAC 432A.546, a licensee of a child care center, child care institution, accommodation facility, facility for special events, nursery for infants and toddlers or special needs facility which is operated between the hours of 9:00 p.m. and 6:30 a.m. shall abide by the following staffing levels in each classroom: Age of Child Required Staff to Child Ratio Group Size Less than 3 years of age 1 caregiver for every 6 children 12 3 years of age or older 1 caregiver for every 10 children 20 3. Every member of the staff of a child care center, child care institution, accommodation facility, facility for special events, nursery for infants and toddlers or special needs facility who is on duty at night shall remain awake during duty hours. 4. A licensee of a child care facility is allowed to utilize all useable and measured square footage within a classroom to meet the requirements of NAC 432A.250 if the requirements for ratios and groups described in subsections 1 and 2 are maintained within such classrooms. 5. If a licensee of a child care facility care for children of different age groups as described in subsections 1 and 2, the licensee shall abide by the required staff to child ratio and group size based on the age of the youngest child in the group. The facility failed to provide an adequate # of staff for the number of infants/toddlers in care. Take corrective action to ensure sufficient staffing in order to provide for children ' s needs.”

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.”

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 304.2

“2. The director shall: (a) Provide a program for child care for the facility which meets the requirements of this chapter. (b) Be physically present in the facility for a sufficient amount of time to ensure compliance with the provisions of this chapter and chapter 432A of NRS. (c) Provide space for an office, the storage of records, conferences with parents, meetings of the staff and all other needs of the program for child care. (d) Maintain organized separate records for each employee that include, without limitation, documents related to training. Such records must include, without limitation: (1) Documents verifying that the employee has, if applicable: (I) Completed the training required pursuant to NRS 432A.177; (II) Received the orientation and basic training required pursuant to NAC 432A.320; (III) Completed the training required pursuant to NAC 432A.323; and (IV) Completed the training required pursuant to NAC 432A.326; and (2) A copy of the documentation concerning, and the results of, the investigation of the employee’s background and personal history which is conducted pursuant to NRS 432A.170, including, without limitation, a clearance letter from the Division or a current child care work card, and a release form for this information completed by the employee. (e) Ensure that each member of the staff of the facility who is not a caregiver, but whose job duties may directly impact children cared for in the facility, has the training necessary to protect the health and safety of the children and the health and safety of the other members of the staff, including, without limitation, training concerning proper nutrition, methods of sanitation and procedures for maintaining a safe environment in the facility. (f) Work with parents and include them, whenever possible, in the programming and functioning of activities. (g) Cooperate with the Division and other agencies of government to improve the quality of child care and the competence of caregivers. (h) Designate a member of the staff who is responsible for the operation of the facility when the director is not present at the facility. The director failed to maintain organized, separate records for each employee that include, without limitation , documents related to training and background investigations. Maintain employee records as required.”

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 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 310.3

“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.”

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.”

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 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.”

NAC 520

“1. A licensee of a child care facility shall have a staff which is sufficient in number to provide physical care, supervision and individual attention to each child and allow time for interaction between the staff and the children to promote the children ' s social competence, emotional well-being and intellectual development. 2. Except as otherwise provided in subsection 3, in addition to the number of caregivers that are required to satisfy the applicable ratio of caregivers to children set forth in NAC 432A.524, one additional caregiver or an adult volunteer per each group of children must be present on all field trips away from the child care facility to assist in providing direct supervision to the children and to increase the safety of the children. 3. The provisions of subsection 2 do not apply: (a) If the purpose for leaving the child care facility is to transport the children from the child care facility to another location and, upon reaching that location, the responsibility for caring for the children is assumed by another adult. (b) To a group of children that is composed entirely of children of school age, including children who are attending kindergarten. 4. A member of the staff of a facility who is supervising a child pursuant to subsection 1 must: (a) Be physically present in the room where the child being supervised is present; (b) Observe, oversee and guide the child; (c) Be aware of the needs of the child and accountable for the care of the child; and (d) Maintain a proximity to the child that allows the member of the staff to be capable of intervening if assistance or direction is needed by the child.”

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.”

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”

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 304

“1. The director of a child care facility is responsible for screening, scheduling and supervising the staff of the facility and for the conduct of each member of the staff at the facility. 2. The director shall: (a) Provide a program for child care for the facility which meets the requirements of this chapter. (b) Be physically present in the facility for a sufficient amount of time to ensure compliance with the provisions of this chapter and chapter 432A of NRS. (c) Provide space for an office, the storage of records, conferences with parents, meetings of the staff and all other needs of the program for child care. (d) Maintain organized separate records for each employee that include, without limitation, documents related to training. Such records must include, without limitation: (1) Documents verifying that the employee has, if applicable: (I) Completed the training required pursuant to NRS 432A.177; (II) Received the orientation and basic training required pursuant to NAC 432A.320; (III) Completed the training required pursuant to NAC 432A.323; and (IV) Completed the training required pursuant to NAC 432A.326; and (2) A copy of the documentation concerning, and the results of, the investigation of the employee’s background and personal history which is conducted pursuant to NRS 432A.170, including, without limitation, a clearance letter from the Division or a current child care work card, and a release form for this information completed by the employee. (e) Ensure that each member of the staff of the facility who is not a caregiver, but whose job duties may directly impact children cared for in the facility, has the training necessary to protect the health and safety of the children and the health and safety of the other members of the staff, including, without limitation, training concerning proper nutrition, methods of sanitation and procedures for maintaining a safe environment in the facility. (f) Work with parents and include them, whenever possible, in the programming and functioning of activities. (g) Cooperate with the Division and other agencies of government to improve the quality of child care and the competence of caregivers. (h) Designate a member of the staff who is responsible for the operation of the facility when the director is not present at the facility. 3. If the facility is in operation 25 hours or less per week, the director must be present in the facility during at least half the hours of operation.”

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 310.3

“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.”

NAC 520

“1. A licensee of a child care facility shall have a staff which is sufficient in number to provide physical care, supervision and individual attention to each child and allow time for interaction between the staff and the children to promote the children ' s social competence, emotional well-being and intellectual development. 2. Except as otherwise provided in subsection 3, in addition to the number of caregivers that are required to satisfy the applicable ratio of caregivers to children set forth in NAC 432A.524, one additional caregiver or an adult volunteer per each group of children must be present on all field trips away from the child care facility to assist in providing direct supervision to the children and to increase the safety of the children. 3. The provisions of subsection 2 do not apply: (a) If the purpose for leaving the child care facility is to transport the children from the child care facility to another location and, upon reaching that location, the responsibility for caring for the children is assumed by another adult. (b) To a group of children that is composed entirely of children of school age, including children who are attending kindergarten. 4. A member of the staff of a facility who is supervising a child pursuant to subsection 1 must: (a) Be physically present in the room where the child being supervised is present; (b) Observe, oversee and guide the child; (c) Be aware of the needs of the child and accountable for the care of the child; and (d) Maintain a proximity to the child that allows the member of the staff to be capable of intervening if assistance or direction is needed by the child.”

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 5205

“1. Except as otherwise provided in NAC 432A.290 and 432A.546, a licensee of a child care center, child care institution, accommodation facility, facility for special events, nursery for infants and toddlers or special needs facility shall, between the hours of 6:30 a.m. and 9:00 p.m., abide by the following staffing levels in each classroom: Age of Child Required Staff to Child Ratio Group Size Less than 9 months of age 1 caregiver for every 4 children 8 9 months of age or older but less than 2 years of age 1 caregiver for every 6 children 12 2 years of age or older but less than 3 years of age 1 caregiver for every 9 children 18 3 years of age or older but less than 4 years of age 1 caregiver for every 12 children 24 4 years of age or older but less than 5 years of age 1 caregiver for every 13 children 26 5 years of age or older 1 caregiver for every 18 children 36 2. Except as otherwise provided in NAC 432A.546, a licensee of a child care center, child care institution, accommodation facility, facility for special events, nursery for infants and toddlers or special needs facility which is operated between the hours of 9:00 p.m. and 6:30 a.m. shall abide by the following staffing levels in each classroom: Age of Child Required Staff to Child Ratio Group Size Less than 3 years of age 1 caregiver for every 6 children 12 3 years of age or older 1 caregiver for every 10 children 20 3. Every member of the staff of a child care center, child care institution, accommodation facility, facility for special events, nursery for infants and toddlers or special needs facility who is on duty at night shall remain awake during duty hours. 4. A licensee of a child care facility is allowed to utilize all useable and measured square footage within a classroom to meet the requirements of NAC 432A.250 if the requirements for ratios and groups described in subsections 1 and 2 are maintained within such classrooms. 5. If a licensee of a child care facility care for children of different age groups as described in subsections 1 and 2, the licensee shall abide by the required staff to child ratio and group size based on the age of the youngest child in the group.”

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 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.”

NAC 200.8

“8. An applicant must, before a license is issued to him or her, submit to the Division a certificate stating that he or she holds a policy of insurance for protection against liability to third persons which will meet the requirement set forth in subsection 2 of NAC 432A.290. 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.”