Lil Explorers School of Boerne

746.2427(a) - AP Must Place Infants in Face up Sleeping Position or Must Have Completed and Signed Sleep Exception Form for the Infant

A 6 mos old infant was observed sleeping on their stomach. Caregiver was asked how the infant was placed in their crib and stated on their stomach.

746.2409(a)(1) - Safety Requirements for Cribs - Snug Fitting, Firm, Flat Mattress Designed for Use in Crib

An infant was observed sleeping in a crib with a mattress that was too small for the crib.

746.611(b) - Health Statement on File within 1 Week of Admission

Two out of 10 child files evaluated were missing health statements upon enrollment.

746.611(a)(3) - Health Statement parent sign - Dated within past yr, name/address health care professional, states child can participate. Follow by signed statement

One out of ten child files evaluated were missing updated health statements from the pediatrician after being enrolled for a year.

746.613(c)(1) - Immunization Exception or Exemption on File and Verified

Two out of ten child files were evaluated. One child had a vaccination affidavit that expired 8/11/25. A second child's vaccination affidavit had partial exemptions noted but did not have a corresponding immunization record showing the vaccinations were received.

746.1403(a)(1)(A) - Training requirements for substitutes, volunteers, and contractors-Orientation

Four volunteer files were evaluated and did not contain a documented orientation.

746.3701 - Safety - Areas Free From Hazards

A storage closet in the restroom of the main house and an under the sink cabinet in the Sassafras room was unlocked. Both contained cleaning chemicals accessible to the children.

746.1315(b) - Each Caregiver and the Director Must Have Current Training in pediatric CPR

Two caregivers did not have a current CPR certificate on file. One expired 7/2025 and the second expired 8/15/2025.

746.613(b) - Immunization Records, Exceptions, and Exemptions Current

A child with a notarized vaccination affidavit on file did not indicate which vaccines the child was exempt from receiving.

746.3819 - Food Allergy Emergency Plan Signed by Parents and Health Care Professional

A child with a food allergy plan on file did not contain the parent's signature.

746.1315(a) - Each Caregiver and the Director Must Have Current Training in pediatric first aid with rescue breathing and choking.

Two caregivers did not have a current first aid certificate on file. One expired 7/2025 and the second expired 8/15/2025.

746.2805(5) - Prohibited Punishments - Humiliating, Rejecting, Yelling

A caregiver was observed yelling at a group of children in the Lilac room in an attempt to have the children clean up.

746.3701 - Safety - Areas Free From Hazards

A sink cabinet in the Sassafras room had a broken safety lock allowing access to cleaning chemicals stored inside. An electric hot water heater in the closet of the Lavender room had a nap cot placed in front of it to prevent access. NOTE: During the inspection, the safety lock was replaced and a shelf was moved in front of the closet to prevent children from accessing the hot water heater.

746.1205(a)(2) - Responsibilities of Caregivers - Know number of children responsible for

The caregiver in the Hawthorne room with a specified age group of 2 year, provided an incorrect headcount of 11 children when asked. Upon review of the classroom attendance roster with the caregiver, it was determined there were 12 children in her care.

746.3501(2) - Diaper Changing Steps- Cleanse Child with Individual Cloths

A child was not thoroughly cleaned after having a soiled diaper.

746.3501(4) - Diaper Changing Steps- Parent's Written Permission for Powders, Lotions, Etc.

Diaper cream that did not belong to a child was applied during diaper changes.

746.603(a)(4) - Children's Records - Immunizations

1 out of 10 child files evaluated for immunization records was missing an updated record.

746.3503(a) - Diaper Changing Equipment - Smooth, Non-absorbent, Easy to Clean Surface

The changing pad in the Sasafras room was a cloth material. NOTE: Changing pad was removed during inspection.