Protocol for Inspections at Child Care Programs

Division of Early Childhood

Office of Child Care

Licensing Branch

Protocol for Inspections

at Child Care Programs

First issuance: October 1, 2019


 
Table of Contents 
 
FOREWORD                3 
The Six Components            4 
Specialist Professionalism          5 
Investigative Techniques          5 
1  Planning and Flexibility           6 
2  Evidence Verification            6 
Entrance Conference and the Tour        7 
Interactions and Interviews          9 
1  Care and Program Assessment          9 
2  Guidelines for Interactions and Interviews      9 
Classroom Observation          12 
Medication Administration Review        12 
Documentation Review          13 
Sample Selection Table          15 
Citation of Violations           16 
1  Using Evidence Gathered from Children       16 
2  Words to Avoid in a Description of Violation      16 
Exit Meeting              17 
Acknowledgements            17 
Appendix A: Entrance Conference Brochure        19 
Appendix B: Request for Information at Entrance Conference  20 
Appendix C: Facility Review Form for Child Centered Care   22 
Appendix D: Sample Interview Questions for Director / Staff  26 
Appendix E: Reference Tool for Classroom Observations    28 
 
   

FOREWORD

The inspection protocol is at the heart of a sustained effort by HQ and field office staff to increase

consistency across the state. It also looks to the future by paving the way for greater participant

involvement in the evaluation of care and services rendered to those in care in the various

children’s programs in the state regulated by the Division of Early Childhood (DEC).

The focus here is on the provider’s ability to meet children’s needs through the actual delivery of

care and services and not just “paper” compliance. The inspection tasks are designed with this in

mind and are inter-connected in order to both identify potential problem areas and verify from

multiple sources any non-compliance discovered during the inspection. The components of

observation and interview are further emphasized and integrated into the inspection process.

The inspection protocol:

 describes DEC’s philosophy on inspections, including the basic components and

inspection strategies;

 gives forms and tools (in the appendices) for specialists to use, as needed, in gathering

information and making investigative decisions during an inspection; and

 should be applied during all inspections.

NOTE: Specialists are given some flexibility in terms of which tools to use and how to

apply them (appendices are optional), but for consistency they may not create their own

(alternate versions of) forms/tools.

It is hoped that by continuing to conduct participant-centered inspections, DEC will promote an

even greater emphasis among providers on the delivery of care and services to children. The

degree to which it is able to achieve this will likely depend on the licensing specialists’ ability to

implement this protocol accurately, consistently, and efficiently.

The inspection is at the center of our work as licensing professionals. Its purpose

is to evaluate and monitor provider compliance with applicable standards for

licensure. It also gives the provider the chance to demonstrate the systems in

place at the program to provide care and services to its participants. In order to

achieve these goals, however, the specialist must effectively complete all the

components of an inspection and employ thorough investigative techniques. This

inspection protocol was created to be a guide for specialists to assist them in the

challenging task of performing an inspection.

1 The Six Components

There are six basic components of an inspection:

 Entrance Conference – Specialists introduce themselves

briefly, outline the basic components of the inspection process

and asks for items they will need to conduct the inspection;

 Tour – Specialists walk through the building(s) directly after the

entrance conference and as soon as possible after arrival in

order to observe activities and personal interactions, talk to

children and staff, examine the physical plant, and check on

general health and hygiene issues;

 Interactions and Interviews – Specialists speak casually to

children, may have discussions with parents (either during or

after an inspection), converse with staff members, and interview

the program director to gather information on compliance with

standards, especially those relating to care and services to

children;

 Observations – Specialists observe – from the moment they

drive up to the building until the conclusion of the inspection –

what is happening in the program in order to assess compliance

with standards. Specialists pay special attention to the

interaction between staff and children, the execution of the

program’s internal policies and procedures, and the learning and

recreational activities;

 Documentation Review – Specialists conduct a focused

examination of child and staff records, targeted on key standards

and information gathered during interviews and observations;

and

 Exit Meeting – Specialists review the results of the inspection

with the provider, listen to and discuss with the provider any

disputed findings and/or comments about the inspection process,

provide consultation, and request from the provider a plan of

correction for any violations and ensuring future compliance.

Note: The specialist will be able to provide the completed Summary of Findings for

signature by the provider at the exit meeting, but if not will at least discuss

preliminary findings.

Though the entrance conference and tour should take place at the

beginning of the inspection and the exit conference at the end, the

other components (or tasks) of the inspection need not occur in any

particular order. This allows the specialist(s) the greatest degree of

flexibility in order to be responsive to the unique circumstances

presented during an inspection at a given program. There is also no

minimum or maximum amount of time required to complete any

protocol component or an inspection generally.

The specialist(s) should be evaluating at all times whether the

children in the program are receiving safe and appropriate care and

services from the provider. The emphasis throughout the inspection

should be on observing children as they go about daily activities and

noting the way staff members interact with them.

2 Specialist Professionalism

As they conduct their inspections, specialists will:

 Treat everyone they meet with dignity and respect, using “people

skills” to make others feel as comfortable as possible;

 Maintain an open dialogue with directors and staff members,

while gathering the information needed to complete a fair

evaluation of the facility’s performance;

 Enforce the regulations and their official interpretations as

written;

 Look for patterns of non-compliance or risk to children, without

being prescriptive in their enforcement of the standards;

 Remain objective during their information gathering, recognizing

that things are not always as they appear at first glance;

 Protect confidential information gathered prior to and during the

inspection, sharing it only with those who have the authority or

permission to receive it; and

 Be aware of their own reactions to interpersonal conflict and

strive to keep the inspection process on a professional footing.

3 Investigative Techniques

The focus of the inspection process should be to assess the actual

delivery of care and services to children. Though the specialist must

evaluate provider compliance with standards about documentation,

his or her foremost concern should be with the well-being of the

children. In order to do this adequately, the specialist must employ

key investigative techniques for every inspection. To inspect means

to check or test an individual or entity against established standards.

Investigation, however, means to observe or study by close

examination and systematic inquiry for the purposes of making a

determination (of compliance) based on an in-depth analysis of facts.

Good investigative techniques should be a component of every

inspection.

This section is borrowed

substantially from Minnesota

Department of Health’s, “10

Commitments for MDH Nurses

Who Survey Assisted Living

Home Care Providers.”

3.1 Planning and Flexibility

Planning is essential in order to conduct a successful inspection. It

assists in determining the pervasiveness and validity of violations, if

there are any, and is an aid in the decision-making process. It

should include both pre-planning before the start of the inspection

and planning during the course of the inspection, since

circumstances are unpredictable.

PROVIDER FILE REVIEW

Prior to the inspection, the specialist should do a thorough review

of the program file, paying special attention to the following:

 The most recent application;

 The most recent staff list, Form 1203, (bring a copy to the

inspection);

 Associated Parties List;

 Most recent Staffing Pattern;

 Any allowable variances and/or stipulations on the license

(photocopy or make a notation of relevant information for

reference during the inspection)

 Floor plan (copy for inspection if necessary)

 The inspection summary and Summary of Findings notice (if

applicable) from the last inspection; and

 Any complaints since the last inspection (review outcomes and

identify any patterns).

A thorough review and analysis of the provider file will help the

specialist determine who may need to be interviewed, which records

and documents will need to be reviewed, and what to carefully

observe. It also helps the specialist gather any evidence that may be

useful during the inspection. The specialist will also need these tools

for the inspection: 1) tablet, 2) tape measure, 3) thermometer, 4)

camera, 5) relevant technical assistance materials (which specialists

often copy onto their tablets), 6) directions and any other travel

items, and 7) program contact information.

Though pre-planning and preparation are essential to the inspection

process, flexibility during the inspection itself is equally important.

Although the specialist may have pre-conceived ideas and a pre-

planned strategy for performing any given inspection, he or she must

be able to adapt as situations change and evidence emerges. The

assumption is that when presented with unanticipated issues (or “red

flags”), the specialist will fully investigate and follow-up, addressing

all potential areas of non-compliance.

3.2 Evidence Verification

Specialists must be thorough to ensure that compliance (or non-

compliance) is accurately determined. It is important to verify

information and to avoid making assumptions about what “appears”

to be the case. For this reason, the specialist should not share

information with children, their parents, or program staff and

administration until he or she has made necessary observations and

gathered adequate evidence. While it is important not to jeopardize

collecting important evidence by discussing concerns with providers

prematurely, it is also essential to inform them of potential violations

at some point prior to the exit conference. This affords the provider

an opportunity to produce information (including documents) that

shows a violation is not warranted and helps specialists avoid

making conclusions without having all the facts. There may well be a

reasonable explanation for what may appear to be a violation during

an initial encounter.

Evidence is always strengthened when it is verified from a variety of

sources. One observation or one document may be sufficient to

support a violation, but serial observations of non-compliance made

over an extended period of time are stronger than a single one.

Along the same lines, an observation that is corroborated with an

interview is strengthened by that interview. An observation, an

interview, and a document combined present stronger evidence than

a single observation, a single interview, or a single document. If the

specialist observes a situation that potentially indicates non-

compliance, it is essential to do the necessary follow-through to

actually make that determination. As much as possible the specialist

should document interactions with children and/or their

parents/guardians, and discussions with staff members and the

director. This would include, again as much as possible, the names

of the individuals, as well as the date, time, and details of the

information shared with the specialist.

NOTE: Since interactions with children will often be informal, with

a group, and in a way that minimizes disruptions to their daily

routine at the program, the specialist may not be able to record all

the specific details mentioned here. It is helpful, however, to

obtain as much information as possible, as this can be very useful

at a later point.

It is essential that the specialist retain any notes in the provider

record and include the details in any description of the violation.

4 Entrance Conference and the Tour

First impressions are very important during an inspection. Through

the entrance conference, the specialist can set a professional tone

for interactions with the program director. Likewise, the initial tour

provides a unique opportunity to begin key observations about a

given program. Through careful observation (paying close attention

to what one sees, hears, smells, and touches) and the information

offered by those he or she may talk to along the way, the specialist is

able to form initial impressions about the program and identify any

potential areas of non-compliance. This information helps the

specialist devise a strategy for implementing the remaining tasks of

the inspection.

In a sense, the tour begins with the first visual sighting of the

program facility. The specialist should note any concerns with the

weaker

evidence

stronger

evidence

exterior appearance and maintenance of the building and any

potential safety issues. He or she should also note whether any

children are outside the building and in what type of activity they may

be engaged. Once inside the building, the specialist should present

photo identification, briefly explain the purpose of the visit, present

the inspection brochure (Appendix A - at least the first time the

inspection protocol method is used at the program and to all new

providers), and hand the director the form What Your Specialist

Needs from You Today (Appendix B). This entrance conference

should be very limited in duration, however, in order that the

specialist may begin the tour as soon as possible. Any delay in

starting this key task (even during complaint investigations), may

greatly diminish the specialist’s ability to obtain valuable information

and insight into what it is really like at the program on a daily basis.

(Reminder: It is Division policy that inspections, except initial and

conversion inspections, should be unannounced).

Introducing oneself during the tour to participants, parents, and staff

is key for the specialist, as this shows he or she is approachable. It

provides an opening for these individuals to convey important

information about the program, which may also inform the

specialist’s strategy for the inspection. This would include which

areas to investigate in greater detail. These interactions, along with

observations during the tour, may also help guide the specialist to

form additional questions to ask during the inspection.

At the beginning of every inspection, specialists must count

staff on duty and note their physical location, number of

children in care, and whether the personnel on duty meet

qualifications and correspond accurately to the required ratios.

All potentially significant observations from the tour (as well as

throughout the inspection) should be recorded legibly with the date

and time and in sufficient detail to adequately and objectively

describe them at any later point. Specialists have the option of using

the Facility Review Form for Child Care Centers and Homes

(Appendix C) for this purpose. The health, safety, and general

welfare of the children in care must be the specialist’s primary

concern. While the physical environment should be noted and

addressed, this is largely to be assessed in terms of its impact on the

children. (NOTE: What Your Specialist Needs from You Today,

mentioned above, is also an excellent tool for obtaining this

information.)

At the end of the tour, the specialists should reflect on the

interactions with children and staff (covered in the next section) and

observations, as well as the information gathered during pre-

planning efforts, to formulate a plan for the remaining tasks of the

inspection. This will include a formal classroom observation(s) or

general child-caregiver observation (at a family child care home

[FCCH]), which will be described in section six, selecting an

appropriate sample for record review and interviewing tasks (see

sample selection table in section nine) in order to determine if a

potential violation is isolated in nature or potentially systemic, posing

greater risk to the children in care.

5 Interactions and Interviews

It has been stated already that the most important element of an

inspection is the specialist’s assessment of the care that children

receive at a program in relation to the program standards. Though

the specialist can gather information about this through observation

and documentation review, interviews and interactions are also

essential for an accurate assessment.

During an inspection at a child care program specialists:

 Interact with children in care;

 Provide an opportunity to have discussions with

parents/guardians;

 Converse with staff members;

 Interview the director; and

 Conduct any other interviews or follow-up discussions if

indicated.

5.1 Care and Program Assessment

The interview process is crucial to the specialist’s ability to make an

assessment of the provider’s compliance with standards related to

the following areas: physical plant, food, services, activities, staff,

supervision, medication, behavioral guidance, inappropriate

interactions, parental involvement, transportation, and emergencies.

Specialists may also receive information through their interactions

and interviews that would cause them to look further into other areas

of the standards to uncover possible non-compliance.

5.2 Guidelines for Interactions and Interviews

Specialists should follow certain principles in their interactions with

children, and their interviews with parents, staff, and program

administration. As a general rule, a specialist should:

 Introduce himself/herself and identify the purpose of the

inspection;

 Develop a rapport with the individual(s), focus questions on the

care and services that the program provides to participants, and

thank the person for sharing his or her views;

NOTE: When children approach the specialists during the tour and he

or she talks to them in casual conversation (see section below), it is

OK to listen and take notes on any topics the children bring up on

their own initiative. This reflects more of the interactive nature of

conversations specialists should have with children, as opposed to

the more formal interview format.

 Document information that would be relevant to a determination

decision such name, date, time, etc.

NOTE: Though not always apparent during an interview or casual

conversation, this information can be very important if used later on

as evidence in support of a violation. The intent here is not to create

extra work during the inspection, but to make the specialist’s job

much easier when it comes to making decisions about whether to cite

and, if so, how to construct the description of violation.

 Consider what is going on at the time of the interaction/interview

in order to obtain routine information in the least intrusive way

possible;

 Discontinue a conversation/interview if to continue would place a

child in an unsafe position at the program;

 Make every effort to protect the identity of the person(s) who

provides information unless he or she gives permission to share

this with the program director; and

 Report immediately to CPS any allegations of abuse or neglect

disclosed during the interviews.

There are also specific considerations for interactions with children,

discussions with parents, and director and staff interviews. These are

outlined below, with some additional information in the appendices of

this protocol.

INTERACTIONS WITH CHILDREN:

During the tour, and/or at any other opportune time during the

inspection, the specialist should engage a few children in casual

conversation about the program. These interactions are essential as

the children in care are the consumers of the care and services at

the program and talking with them will give important insight into their

experience and general level of satisfaction with the program. The

conversations should be casual, brief, and friendly.

Examples of the type of questions that may be used with

children include:

Tell me what you’re doing today.

What do you like about school?

What was your snack today?

DISCUSSIONS WITH PARENTS:

Specialists should make themselves available and accessible to any

parent (or guardian) who wishes to speak with them during or after

the inspection. Parents may also wish to speak to the specialist at

another point by phone. Information gathered from these

discussions can give the specialist important insight about the care

and services provided to children in a particular program and can

influence the specialist’s decisions about the inspection and its

outcome. Information received after the specialist has finished

documenting and syncing the inspection to CCATS should be

evaluated and may be considered as possible material for a

complaint.

CONVERSATIONS WITH STAFF:

Conversations with staff are also a part of the licensing specialist’s

interaction during a tour of a facility or as part of a separate

interview, if warranted. As with interactions with children, questions

for staff will normally be part of general conversation during the

facility tour. The licensing specialist should determine the extent and

focus of questions for staff based on the history of the facility and

what is discovered during the course of the inspection. If concerns

are noted, more in-depth interviews are indicated.

Examples of the type of questions that could be used with

staff and the areas that could be addressed include:

What are your responsibilities here? What is your job title?

How many children do you have directly under your care?

How were you informed of your job duties and/or shown

what to do when you started?

What is the procedure when a staff person is absent?

If there is an emergency that requires evacuation, what are

you personally required to do?

When was your last emergency drill? Fire drill?

When the director is absent, who’s in charge?

How do you deal with a difficult child?

What training have you had about reporting child abuse?

How is suspected child abuse reported at your program?

What is the school’s procedure for changing diapers, potty

training, restroom time for children, etc.?

What are you expected to do if a child in your care is

injured?

DIRECTOR INTERVIEWS:

In addition to conversations with staff members, the specialist will

also interview the director of the program to obtain important

information about operations and the care and services provided to

children. The scope and number of questions will depend on the

compliance history, what is observed during the inspection, and

items discussed with children, staff, and/or parents. Sample

interview questions can be found in Appendix D (for CCCs &

FCCHs).

6 Classroom Observation

At all child care programs the specialist will complete a formal

classroom observation in addition to observations made

throughout the tour. (NOTE: This would be general child-caregiver

observation, not a “classroom” observation, at a family child care

home.) The specialist must first find a comfortable, inconspicuous

spot within a classroom and simply observe what is happening there

for a period of 10 minutes, at minimum. The specialist will observe

interactions between the (lead) caregiver and the children, as well as

any other activities that may be taking place in the classroom.

Appendix E provides a useful reference for specialists to review prior

to or after the classroom observation. However, this tool is not

intended to be used as a form, nor should the specialist reference it

during the classroom observation. The specialist should simply

observe, though it is acceptable for him or her to make notes of

these observations, particularly if they may trigger further

investigation and/or may be an indication of provider non-compliance

with standards. The specialist will want to pay careful attention to

areas of potential concern based on any history of noncompliance at

the program and what is discovered throughout the inspection.

Once the observation is completed, the specialist should review the

results to follow up on any items that may need further investigation.

Follow-up activities might include further discussion(s) with some of

the children in care, staff members, and/or the director; a review of a

particular child or staff member’s record; an analysis of any written

policies and procedures; and/or going through information on staff

training.

7 Medication Administration Review

If the specialist discovers – either through interactions/interviews or

through information obtained by using the form What Your Specialist

Needs from You Today – that the provider administers medication to

children in care, he or she should complete a review of medication

administration requirements. The specialist should first review the

facility’s medication documentation to ensure the name, type of

medication(s), dosage, and the date/time of administration has been

recorded for each child. Next, the specialist should review the actual

bottles/containers for the medications to see if what is listed on the

label matches what is recorded on the Medication Administration

Authorization Form OCC Form 1216. In addition, the specialist

should review the Medication Authorization Form to ensure that all of

the permissions are in place. The specialist should include in the

medication administration review, if applicable, any emergency

medications, over the counter products, and/or topical skin products.

Any errors or inconsistencies should be noted and considered as

possible evidence in support of a noncompliance. Finally, the

specialist should observe and discuss the storage of the medication

to ensure that it is stored in compliance with directed guidelines, out

of reach of children and readily accessible to each employee

designated to administer medication.

8 Documentation Review

This section and the sample selection table in section nine outline

the minimum requirements for children and employee record reviews

and general documentation review. These must be met for all

annual inspections. The specialist must ensure as well that the

sample size for record reviews (as with interactions/interview and

classroom/caregiver interaction observations) is sufficient to

determine whether there is noncompliance and, if so, its

pervasiveness. This is critical in determining how many children may

be affected or potentially affected by the provider’s noncompliance.

If the specialist identifies an issue in one area or for one child, he or

she must also determine if it is a problem for others for the simple

reason that as the pervasiveness of a problem increases, so does

the risk of harm to any child in care. There is a balance specialists

must find, however, between being thorough and using their and the

provider’s time efficiently. It is important that specialists work

strategically and efficiently in the time spent on-site with

documentation review. If one is not careful, too much of the limited

amount of time at the program can be spent on this task with little

result, instead of focusing primarily on interacting with and observing

those in care at the program. Specialists must collect sufficient

evidence to make a compliance determination, but must also know

when they have been reasonably thorough and should stop. The

best way to ensure this is to determine before starting documentation

review exactly which items need to be verified and/or investigated in

the sample files and general documents, based on potential problem

areas or noncompliance identified through observations and

interactions/interviews. Specialists may use the Facility Review Form

for Child Care Centers and Homes (Appendix C) to assist them in

documenting items discovered through documentation review.

CHILDREN’S RECORDS:

Specialists should at minimum examine the following standards in

their strategic review of children’s records in the sample they have

selected:

 Parent agreements/authorizations

 Emergency cards/ contacts

 Physical / Immunization

Based on the program’s history and/or items of potential concern

identified through observations and interactions/interviews during the

inspection, the specialist may also want to examine other aspects of

the children’s records. This is useful to help corroborate any

evidence gathered from other sources, determine the pervasiveness

of any deficiency, and/or assess the risk that may be associated with

the noncompliance.

EMPLOYEE RECORDS:

Specialists should at minimum examine the following standards in

their strategic review of employee records:

 Background checks

 Staff qualifications

 Medical w/TB screening, if indicated

 First aid/CPR and Medication Administration Training (if

required)

 Staff training

 Orientation

As with children’s records, the specialist may want to examine other

aspects of the employee records if this is indicated from the

program’s history and/or items identified through the inspection.

OTHER DOCUMENTATION TO REVIEW AT EACH INSPECTION:

In addition to children and employee records, the specialist should

also review specific documentation of a general nature at the

program. This would include the annual health and fire inspections,

emergency and fire drill documentation (requested from the provider

through the What Your Specialist Needs from You Today form), and

items relating to any allowable variances (if applicable), which must

be reviewed annually.

9 Sample Selection Table

Minimum sample selection for record reviews, the classroom/child-

caregiver interaction observation, and review of medication

administration during inspections at programs are as follows:

NOTES ON COLUMN THREE: For children’s records, the specialist must:

 review children’s records for every child under the age of 2 years.

 include in the sample records from both newly enrolled children and

children enrolled prior to the last inspection.

EXAMPLE: If there are 50 children at the center such that the specialist

must review 10 records, he or she would look at records for two new

children, as well as those of eight other children in care.

NOTE: The specialist may review more records to evaluate compliance

as needed, based on what is indicated from the history of compliance

and/or information gathered during the inspection. Staff records for

multiple facilities owned by the same entity and kept at a central

location must have copies on file at each location.

NOTE ON COLUMN FOUR: If only one classroom is available, then the

specialist should spend the total amount of time observing that one

classroom. (Example: In a YMCA afterschool program with 55 children, but

just one classroom, the specialist could meet the requirement of three 10-

minute observations by conducting just one 30-minute observation.)

It is essential that the specialist select which records to review based

on the information he or she has gathered during the inspection.

The specialist should not ask the provider to choose which records to

include in the sample. Even if the specialist would like the sample to

contain a randomly selected record, he or she should ask the

provider to deliver record X (child’s name). The specialist can

usually determine the child’s name from what the provider has

already provided with the form What Your Specialist Needs from You

Today or from his or her interactions with children and employees

during the tour.

Number

children

in care

today

Staff

Ensure that staff

have complied

with background

check

requirements for

all household

members and/or

staff

Minimum

Number of

children’s

record

reviews

Number of

classroom

observations

10 minutes

minimum per

observation; if

more than one

is required,

each must be in

a different

classroom

Review of

Medication

Administration

If medications are

administered to

the children in

care, check all the

medications for the

following # of

children

(All records

must be

reviewed for

children under

age 2)

1 – 12

ALL

20%

ALL

13 – 49

ALL

20%

ALL

50 - 99

ALL

20%

ALL

100 &

above

ALL

20%

ALL

10 Citation of Violations

Inherent in the philosophy of the regulatory environment is the

concept of culpability. The specialist must always ask, “Did the

provider have knowledge of this, or should the provider have known

about it?” Observations that are incidental, statements from

interactions/interviews that are not corroborated from other sources,

and/or missing or incomplete items discovered during documentation

review do not necessarily constitute a violation. The specialist must

ensure that he or she has all possible evidence in order to avoid any

subjective generalizations when making decisions about

noncompliance. It is useful to ask the provider questions, throughout

the course of the inspection and/or prior to making violation

decisions, to clarify various matters and to avoid making pre-

judgments without having all the facts.

10.1 Using Evidence Gathered from Children

Because evidence is always strengthened when it is verified from a

variety of sources (see section 3.2), specialists are encouraged to

include information obtained from interactions with children

whenever relevant. The specialist should consider statements from

a child since children are in a great position to give an account of the

care and services they receive in a program. When assessing

statements from children as evidence to support a “description of

noncompliance”, the specialist must consider the child’s level of

understanding and ability to express his or her views.

10.2 Words to Avoid in a Description of

Violation

Specialists should avoid “subjective generalizations and words that

imply a conclusion that is not supported by the evidence.” This is

particularly important when recording and documenting observations

of and interactions with children. Certain words should be avoided,

especially in the description of noncompliance. Here are some

common red flag words to avoid:

Feelings cannot be objectively observed. Avoid these red flag

words: happy, sad, mean, kind, angry, mellow, apathetic, bored,

interested, proud, sympathetic, understanding, nasty, mischievous,

lazy, crabby, laid-back.

Intelligence cannot be objectively observed. Avoid these red flag

words: smart, bright, dumb, mediocre, above-average, overwhelmed,

overachiever, underachiever.

Reasons for doing things cannot be objectively observed. Avoid

these red flag words: provoked, tricked, determined, undirected, out-

of-control, motivated, spiritual, conscientious.

Self-concept cannot be objectively observed. Avoid these red flag

words: weak, competent, pretty, athletic, strong, secure, insecure.

The specialist should instead use factual descriptions of what he or

she observed and/or direct statements (short quotations whenever

possible). He or she should observe all confidentiality requirements,

which include utilizing children’s initials on inspection summaries and

’

“

’

”

(

)

Summary of Findings notices (such as, A.B. or C.D.) with

corresponding identities listed on a supplemental page.

11 Exit Meeting

The exit meeting takes place between the specialist and licensee (or

designee) at the completion of an inspection. The purpose is for the

licensing representative to deliver and review the inspection

summary, answer any questions from the licensee, see if there is

anything he or she may have missed that the licensee can supply to

demonstrate compliance, provide technical assistance, and indicate

findings when there are noncompliances. The specialist may also

use the exit meeting to discuss recent changes or new

interpretations of licensing regulations, refer the provider to

additional resources that might enhance understanding and

compliance with standards, and give feedback on the provider’s

ideas for plans of correction for any violations.

12 Acknowledgements

The Division of Early Childhood would like to acknowledge that some

of the materials in this document were inspired by and adapted from

the following sources:

 A Guide to the Survey Process for Assisted Living Home Care Providers (November

2004) and ALHCP 2620 Informational Memorandum: Licensing Survey Form (July

2006), Minnesota Department of Health.

 State Operations Manual, Appendix P: Survey Protocol for Long Term Care Facilities

(Revision 22: December 2006) and Principles of Documentation for the Statement of

Deficiencies (2000), Centers for Medicare and Medicaid Services, United States

Department of Health and Human Services.

 Alan Jefferson (Director, Northwest Region, Commission for Social Care Inspection,

United Kingdom), “Putting People Who Use Care Services at the Center of Our Work,”

a presentation by at the 16

Annual Licensing Seminar of the National Association for

Regulatory Administration (Richmond, Virginia: October 8-10, 2007).

 Patricia Marickovich, “Observation and Recording: It’s Not Always Obvious,” a four

hour class sponsored by the Division of Child Care and Development (fall 2006),

Virginia Department of Social Services.

 Special thanks to the Virginia Department of Social Services for sharing their Protocol

for Licensing Inspections.

Appendix A: Entrance Conference Brochure

Optional form

Appendix B: Request for Information at Entrance Conference

Optional form

Office of Child Care

Licensing Branch

WHAT YOUR SPECIALIST NEEDS FROM YOU TODAY

Fill in blank spaces and use the back of this page and/or attach additional pages for lists:

 Current email address of facility/program director __________________________________

 Today’s attendance _________________ and total enrollment_______________________

 Names of the following:

o New hires (if applicable) since last inspection (_______________)(date)

o Van/vehicle drivers (if applicable)

o Substitutes

o Any children with special needs

 Are there any children taking medication while at the facility/program? (Yes/No) ______

 Any injury reports since the last inspections

 Documentation of fire and evacuation drills

 Current fire inspection (so specialist may review)

 Current liability insurance/ Workmen’s Compensation as required (so specialist may review)

CHILD CARE CENTERS ONLY:

 Current health inspection (so specialist may review)

 Names of new/promoted program staff (if applicable)

FAMILY CHILD CARE HOMES ONLY:

 Names and birthdates of children present

 Names of new household members (if applicable) since last inspection

(___________________________________)(date)

Facility: ________________________________________________

Date: _______________________

Appendix C: Facility Review Form for Child Care Centers and Homes

Facility Review Form for Child Care Centers and Homes

Facility Name:

Inspection Date:

Specialist Name:

HOW TO USE THIS FORM:

This is an optional form, which can be used to assist the specialist in taking notes (in the margins or on

the back) and keeping track of key standards for observation and review during the inspection. If

notations are made on this form relative to a citation, it should be retained in the facility record, along

with any other notes, forms, or other materials applicable to a citation(s) that results from the inspection.

Key areas of observation:

CHILD CARE CENTERS:

Classrooms

Furniture and equipment age appropriate and in good repair

Center is properly heated and cooled

Drinking water readily available

Storage for children’s belongings

Space sufficient for number of children being served

Space approved

Bathrooms and Toileting Area:

Toilets flush? Faucets work?

Toilets and sinks reachable by children

Water temperature

Toilet paper, paper towels and soap available

Bathrooms clean

Inspection of Food-Service:

Menu posted; if applicable, substitutions indicated

Required food groups served

Food-preparation area clean and free of hazards

Cleaning supplies out of reach of children, stored away from food & separate from food supplies

Adequate food for meals and/or snacks

Food allergies

Inspection of Playground/Pool:

Climbing structures, swings, slides and other large play equipment securely anchored

Resilient surfacing

Drinking water readily available on or near the play area

Shade Provided (June, July, August)

Equipment developmentally appropriate for age group

Playground free of hazards

Facility Review Form for Child Care Centers and Homes

Facility Name:

Inspection Date:

Specialist Name:

CHILD CARE CENTERS (cont.):

Napping Equipment:

Sufficient cots and mats, linens for each child in care

Linens clean

Napping children properly supervised (within ratios)

Infants/Handwashing/Diapering:

Furniture and equipment age appropriate and in good repair (e.g., High chairs or feeding tables

have broad-based legs, safety strap? Plastic seats in good repair? Trays lock onto the chair?)

No Infant walkers

Sanitary and cleaning solution out of infant’s reach

Changing tables covered with nonabsorbent surface?

Caregivers wash hands before and after each diaper change and before each feeding

Toys safe, with no sharp edges, splinters or points, nor made of small parts that can be pulled off

and swallowed

Cribs or other appropriate napping equipment available for each infant

Bedding separately identified and stored for each infant

Placement of cribs, cots or mats allows for entry to/exit from the napping space

Health-Related Services:

Medication properly labeled and stored in original container

Children greeted and checked for illness

First Aid supplies and flashlight, 1st aid and CPR certified staff available

Transportation:

Vehicles in good repair

Appropriate safety belts and child restraints

Posting Requirements:

License

Emergency plan

Evacuation procedures/maps posted

Emergency Numbers posted including 911

Daily schedule

Facility Review Form for Child Care Centers and Homes

Facility Name:

Inspection Date:

Specialist Name:

FAMILY CHILD CARE HOMES:

A physical plant inspection covers overall maintenance and operations, such as equipment and

supplies, building and grounds (including an inspection of the garage), food-preparation areas,

bathrooms, storage areas, lighting, medication and cleaning supplies, napping arrangements and

compliance with fire clearances.

Provider or substitute provider is continuously present when children are in care

Home is clean, free of hazards, properly heated or cooled

Home has a working telephone

Children’s toys, equipment and materials are safe and age appropriate

Children are excluded from home if infectious

Food brought from the children’s homes is labeled with the child’s name and properly stored or

refrigerated

Fireplaces and open-face heaters are screened

Children under 5 do not have access to stairs

Poisons, detergents, medicines are inaccessible to children

Firearms or dangerous weapons are in locked in a container(s), compartment(s), or cabinet(s)

and ammunitions is stored separately

Pools, hot tubs or other bodies of water are made inaccessible by a pool cover, fence, or other

appropriate barrier

Outdoor play areas are fenced (if within 30’ of a hazard)

Infant walkers are not used for child care

Children are free from corporal punishment, physical or mental abuse, or interference with daily

living functions

There is no smoking in the home where care is provided and children are present

If transportation is provided, the vehicle is in good repair; appropriate safety belts and child

restraints available

Posting of current registration

Posting of emergency numbers

Facility Review Form for Child Care Centers and Homes

Facility Name:

Inspection Date:

Specialist Name:

KEY AREAS OF DOCUMENTATION REVIEW:

Records Review (CCCs and FCCHs):

Staff Files (of staff records not previously reviewed)

Background checks (also review any background check waivers, if applicable)

Staff qualifications

Medicals

First Aid/CPR certification, and Medication Administration Training

Staff training

Children’s Files

Parent information

Emergency contacts

Physical/Immunization

Proof of ID (Recommended)

Notice of liability insurance (if required)

General Documentation Review (CCCs and FCCHs):

Fire Inspection

Evacuation/Fire drills

Annual review of allowable variance(s) if applicable

Appendix D: Sample Interview Questions for Director/Family Child Care

Provider - Optional

Sample Interview Questions for Director/Family Child Care Provider

(Note: This is intended to be a tool for specialists, who are given flexibility on how to use it from one

inspections to the next. The scope and number of questions will depend on the compliance history, what is

observed during the inspection, and items discussed with children, staff, and/or parents.)

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Facility Name: ________________________________________ Inspection Date:

Specialist Name: ______________________________________

(Person(s) Interviewed: ________________________________

NUTRITION

 How do you ensure that foods posing a high risk of choking for infants and toddlers (e.g., hot

dogs, whole grapes, hard raw vegetables, popcorn, and whole nuts) are not given to them?

 How do you ensure that appropriate snacks and meals are provided?

 How do you inform staff that a child has a disability, food allergy, medically based dietary needs,

or other special dietary needs that requires accommodation? How do you know when you need

to modify a menu/accommodate for this child?

 What kinds of food do you serve to children? How do you ensure that you are meeting age-

appropriate nutritional requirements? Do children have to eat all of the food offered? Are there

times when children are not allowed to have something offered or given something extra

because of behavior?

 Do staff members sit down with children at meal time? Is conversation shared during the meal?

DIAPERING/TOILETING PRACTICES

 Describe practices related to potty use.

 Describe diapering practices in detail.

 How is the clean-up of bodily fluids handled?

 Are gloves available to staff, where ae the gloves kept and how does staff determine whether or

not they use gloves?

HEALTH AND SAFETY OF INFANTS AND TODDLERS

 Are infants held during breast feeding? If not, describe.

 When and how often are toys sanitized? Review toy sanitation schedule, if available. What

products do you use to sanitize toys? Can you show me the product?

 What precautions are taken to ensure each child received his or her own mother’s breast milk or

the correct formula?

CLASSROOM SIZE AND STAFFING

 How many staff members are in the classroom? How many children are in the classroom? How

many children are assigned to each teacher?

 When are parents allowed to visit the program and observe children?

 How do you ensure the children are supervised at all times?

 Whom do you tell when facilities and/or equipment is unsafe or in need of repair?

FIRST AID KITS

 Do all staff working with children know where the first aid kit is located?

 Are all items in the kit within the expiration date applicable?

 Are kits inaccessible to children

 Is there a portable kit to use on field trips or on the playground?

TRAINING

 When do you receive training on identifying and reporting child abuse and neglect? What steps

would you take if you suspected child abuse or neglect?

 Describe the opportunities for ongoing job-related training?

TRANSPORTATION

 How often do you transport children?

 How do you know the people to whom each child can be released?

 How do you monitor children when they have to cross the street?

 How do you ensure a child is not left in the vehicle at the end of the route?

ADDITIONAL QUESTIONS SPECIFICALLY FOR FAMILY CHILD CARE HOMES

 Are smoke detectors installed?

 What is the system of supervision that assures safety of children not within view for a period

(e.g., the provider needs to use the bathroom or an infant is napping in one room while toddlers

play in another)?

 How many children are enrolled? What are their ages?

Appendix E: Reference Tool for Classroom Observations

(This tool is not intended to be used as a form, nor should the specialist

reference it during the classroom observation. Instead, inspectors may

review it prior to or after the classroom observation.)