LE JARDIN WINDWARD OAHU ACADEMY EXTENDED DAY PROGRAM

HAR §17-896.1-3 — Annual Background Clearance Check

The following staff have expired or soon-to-be expiring annual background clearance checks: XXXXX. Please have these individuals complete the DHS 948 Authorization for Background Check and to Release Findings form and provide the Worker the completed copies for processing.

HAR §17-896-7 — Information on owner or operator

Please provide the Worker a DHS 953 Statement of Legal Authority to satisfy this requirement. Please visit the following for the required forms: View official inspection document Correction: The Worker received the DHS 953 Statement of Legal Authority.

HAR §17-896-9 — Admission policies that require sufficient information and instruction to be received from parents or guardians that enable caregiver to care for the child

The Worker received the Student Info Card which collects: (1) The child's name, date of birth, and address; (2) Parent/guardian names and addresses; (3) Parent/guardian phone numbers and emails; (4) Name and phone number of persons to assume responsibility when parents/guardians are not available. However, the Student Info Card does not collect the address of the persons to assume responsibility when parents/guardians are not available, and the name, address, and phone numbers of person authorized to take the child away from the facility. Please provide the Worker a form which collects this information. Correction: The Worker received the sample of the student information card with emergency contacts included.

HAR §17-896-29 — Plan practiced at regular intervals

Please provide the Worker a log of the emergency preparedness drills and fire drills conducted during the Extended Day Program from January 2025 to September 2025. As a reminder §17-896.1-61 Disaster plan for emergencies (c) states that the facility shall complete practice drills for the various emergency situations at regular intervals, or whenever a new procedure has been added. As such, if you do not have a log of the emergency preparedness drills and fire drills conducted from January to December 2025, please begin conducting drills for the various emergency situations during Extended Day care and keep a monthly record. Please provide the Worker a copy of the log for the upcoming months from December to March 2025. Correction: The Worker received a drill log showing consistent drills being conducted.

HAR §17-896-24 — Annual Nutrition review dated: <date>

The Worker received an updated Extended Day Parent Handbook for the school year of 2025-2026. On page 8, it states under Holiday Care Participation: "Lunch and snacks are not provided and parents must pack their own lunch and snacks unless indicated on the Activity sheet in which case a catered company will provide the meal." Under Extended Day Snacks it states: "During Extended Day, K-8 students must bring their own afternoon snack and drink from home." However, it also states on page 12 under Extended Day Lunch and Snack: "During Fall Break, Spring Break, and PDD Care Days a nutritious afternoon snack will be provided for those staying past 2:30pm." Additionally, the Worker received an AM and PM snack menu originally for Le Jardin Academy (LJA) Preschool's 3-4 year olds. Given this collection of information, please first amend the Parent Handbook to provide a clear snack/meal policy for all types of enrollment in the K-8 Extended Day Program (i.e., Extended Day after school, Holiday Care, and for Holiday Care with Extended Day add-on). Please ensure that the policy addresses AM snack, PM snack, and lunch. If LJA is providing any snack/meal service, which includes collecting orders/payment for a catering service, then a menu review is required. If LJA is not providing any snack/meal service, or if parents are submitting orders/payment directly to a catering service, then no menu review is required. For all food provided by the facility, please obtain a satisfactory menu review from the Hawaii Child Care Nutrition Program or from a qualified nutritionist to verify that the menu(s) for snacks and lunch is meeting nutrition requirements. Please provide the menu review to the Worker for verification. As a reminder, the child care facility's food service shall be reviewed biennially by a qualified nutrition consultant. Please see View official inspection document for details regarding the Hawaii Child Care Nutrition Program. Please email DOH.menureview@doh.hawaii.gov to request a menu review. Correction: The Worker received a satisfactory menu review for AM snack, PM snack, and lunch from the Hawaii Child Care Nutrition Program.

HAR §17-896-21 — One caregiver with current certificates during operating hours

Please provide the Worker all unexpired staff pediatric first aid and child CPR certifications. Please also provide a DHS 957 Staff Sequence form to verify that all hours of child care are covered by at least one staff member with an unexpired department-approved pediatric first aid and child CPR certification. Please visit the following for the required forms: View official inspection document Correction: The Worker received American Red Cross Adult and Pediatric First Aid/CPR certifications for eleven (11) current staff members. The Worker also received the DHS 957 Staff Sequence form and verified all hours of child care are covered by at least one (1) staff member with current certifications.

HAR §17-896-18 — Health consultation provisions

All programs shall have on file written evidence that an arrangement has been made with a health care professional to provide consultation. Please provide the Worker a written health consultation agreement letter for the current school year. Correction: The Worker received the health consultation between the school and XXXXX for the school years of 2024-2026.

HAR §17-896-11 — Daily schedule of activities & menu

The Worker received the menu sent on November 20. However, the menu is the AM and PM snack menu for Le Jardin Academy Preschool's 3-4 year old children. If you are serving snacks and/or meals, please provide a menu that is specifically for the grade school children in this K-8 Extended Day Program license. If the BAS program is not serving any snacks and/or meals, including Holiday Care, please amend the Parent Handbook to specifically state that LJA does not serve any AM snack, PM snack, and lunch during all Extended Day and Holiday Care hours, and that parents are required to provide their child with those snacks and lunches. Note: §17-896.1-47 Daily nutritional needs states that when a program is providing meal service, the minimum components and food amounts required by the United States Department of Agriculture (USDA) child care food program shall be met. Please have a qualified nutritionist review the menu to ensure that the menu meets USDA requirements for the ages in the BAS program. Correction: The Worker received a menu for AM snack, PM snack, and lunch.

HAR §17-896-34 — Food service permit dated:

Please provide the Worker an unexpired food establishment permit. If you do not have a current food establishment permit , please provide the Worker a copy of the current Department of Health Green Placard for Le Jardin Academy and the accompanying Food Establishment Inspection Report showing no violations to satisfy this requirement. Please see View official inspection document for details on the Food Establishment Inspection Report. Correction: The Worker received a current Food Establishment Permit for Le Jardin Academy. Permit #XXXXX, expiration 09/10/2026.

HAR §17-896-3 — Criminal history check

Please have the following staff complete the DHS 948 Authorization for Background Check and to Release Findings form for the following: XXXXX Note: All minors must have a parent initial all boxes, print their name, signature, and date page 2 alongside the employee. Additionally, all sections of pages 1 and 2 of the DHS 948 must have a response. Please check your staff's forms to ensure that all sections are fully completed with an appropriate answer, or has "N/A" if not applicable. All new hires, or returning employees with 180-day break in service at a licensed facility, must be fingerprinted with the Department of Human Services (DHS). Please have the following staff schedule a fingerprint appointment with a DHS office immediately: XXXXX Please see the attached DHS 961 Instructions for Background Check for Oahu - Child Care Licensing form for more information. Correction: The Worker received all DHS 948 Authorization for Background Check forms.

HAR §17-896-3 — Employment history check

Please provide the DHS 959A Self-Certification of Employment and DHS 959 Employment History forms for the following new staff: XXXXX. Please provide the following amended forms: Please have XXXXX amend her DHS 959A Self-Certification of Employment form to include at least two (2) mailed attempt dates under "Date EHC Mailed" for all places of employment, including XXXXX. Please have XXXXX amend her DHS 959A Self-Certification of Employment form to include at least two (2) mailed attempt dates under "Date EHC Mailed" for all places of employment, including XXXXX. Employment History Instructions: Required individuals shall complete the form DHS 959A "Self Certification of Employment" and list the places of employment within the past three (3) years including periods of unemployment, self-employment, and periods of school attendance. For every place of employment listed, complete and sign Part I of the DHS 959 "Employment History Clearance Form" (EHC) and have the former and/or current employer complete and sign part II. Please complete the following information on the form DHS 959A: Date EHC mailed and Date EHC returned. Keep copies of all forms mailed out to former employers. If EHC forms are not returned after the first try, mail out the copy again and log the 2nd date mailed. If forms are not returned after the second try, we will accept the self-certification. Please visit the following for the required forms: View official inspection document Correction: The Worker received satisfactory employment history clearances for the requested staff.

HAR §17-896-28 — Personal health habits for staff

The Worker did not receive a current Extended Day Program Employee Handbook, and resorted to using the version used during the previous biennial licensing visit from 2023. Please update the Employee Handbook to include the following: (1) That alcoholic beverages shall not be consumed prior to and during the hours of operation at the facility. If alcoholic beverages are stored at the facility shall be locked up an inaccessible to children. (2) That medication which impairs or limits the staff's ability to provide care shall not be consumed prior to or during the hours of child care. Please provide the Worker the updated Employee Handbook to verify that the amended handbook meets the licensing rules. Correction: The Worker received the amended Employee Handbook.

HAR §17-896-29 — Written plan approved by fire inspector, health consultant or red cross

The Natural Disaster/Emergency Plan in the Extended Day Parent Handbook (SY 2023-2024) includes written procedures for fire, tsunami, hurricane/topical storm, flood, and earthquake. Please provide the Worker an amended and updated Extended Day Parent Handbook which contains the Disaster Plan to include the following: Relocation - Please define where the "place of refuge" is so that parents who cannot establish contact with the school know where to go to find their children in the even that the facility becomes uninhabitable or if the facility is ordered to evacuate. Sheltering in place - Please include written procedures for sheltering in place at the facility. Lock-down - Please include written procedures for lock-down of the child care facility. Providing for the needs of children with disabilities and children with special needs during an emergency - Please include in the Emergency Plan written procedures for providing for the needs of children with disabilities and special needs. Providing for the needs of children with chronic medical conditions during an emergency - Please include in the Emergency Plan written procedures for providing for the needs of children with chronic medical conditions. Correction: The Worker received amended Emergency Procedures with all the requested information.

HAR §17-896-20 — Emergency care provisions

Please provide the form(s) used to collect the child's information which contains: 1) The name, address, and phone number of a physician or health resource that shall be called in case of an emergency; 2) The name of the nearest hospital where such care may be provided; 3) Permission of the parent or guardian to call the stated physician or health resource, or the hospital or clinic, the parent/guardian cannot be reached in case of a health emergency. Correction: The Worker received the Consent to Treat form which collects this information and permission from the parents/guardians.

HAR §17-896-3 — Inspection of facility, activities, records, staff

The Worker was not able schedule a phone interview with the Program Manager. Please contact the Worker to schedule a phone interview at (808) 587-5268 to review the licensing requirements. Correction: The Worker conducted a phone interview with Program Director XXXXX and discussed the licensing rules and regulations.

HAR §17-896-11 — List of staff members and position

We received the completed page 1 of the DHS 954 Staff and Volunteer Listing via email on 2/27/26. Please complete page 2 for all the current staff as well. Please visit the following for the required forms: View official inspection document Correction: The Worker received the DHS 954 Staff and Volunteer Listing with page 2 completed.

HAR §17-896-6 — Other policies

Please provide the Worker an amended Parent Handbook which shall include the following under §17-896.1-11 Statement of operation policies: (20) Grievances - Please include at the end of the Grievance policy in the Parent Handbook on page 9 that should parents/guardians wish to file a complaint with the Department of Human Services following the school's grievance procedure, then they may call Child Care Licensing Unit 1 at (808) 587-5266. (21) Mandated reporting - Please include the following in the mandated reporter policy: "In accordance with Chapter 350 Hawaii Revised Statues, any mandated reporter who has reason to believe that child abuse or neglect has occurred or that there exists a substantial risk that child abuse or neglect may occur in the reasonably foreseeable future, shall immediately report the matter orally to the department or to the police department. All child care providers and employees in all licensed child care facilities and homes are mandated reporters." Correction: The Worker received the Parent Handbook with satisfactory corrections to the grievance and mandated reporter policy on page 9.

HAR §17-896-6 — Whether meals are served

The Worker received an updated Extended Day Parent Handbook for the school year of 2025-2026. On page 8, it states under Holiday Care Participation: "Lunch and snacks are not provided and parents must pack their own lunch and snacks unless indicated on the Activity sheet in which case a catered company will provide the meal." Under Extended Day Snacks (pg. 8) it states: "During Extended Day, K-8 students must bring their own afternoon snack and drink from home." However, it also states on page 12 under Extended Day Lunch and Snack: "During Fall Break, Spring Break, and PDD Care Days a nutritious afternoon snack will be provided for those staying past 2:30pm." First, please amend the Parent Handbook to have all food information under one comprehensive section. Second, in the food section, clarify if the program will provide an AM snack, PM snack, and/or lunch, or if the parents must provide some or all snacks and lunch. If the program will only provide AM snack, PM snack, and/or lunch during specific occasions, please specify when those occasions are. Additionally, if parents are able to receive AM snack, PM snack, and/or lunch from a catering company, please specify the name of the company and how the parents will be able to order and pay for their child. Please provide the Worker an amended Parent Handbook with these changes. Correction: The Worker received a satisfactory amended Parent Handbook with the lunch and snack information clearly stated on page 12.

HAR §17-896-36 — Public beaches, swimming activities and wading pools

The Worker received an American Red Cross Lifeguard (including deep water) with CPR/AED for Professional Rescuers and First Aid certification for XXXXX, which will expire March 22, 2027. The Worker must review the rules with the Program Manager. Please contact the Worker to schedule a phone interview to review the licensing requirements. Correction: The Worker reviewed the licensing requirements with the Program Manager.

HAR §17-896-30 — Written accident prevention policies reviewed annually with staff

The Worker must review the rules with the Program Manager. Please contact the Worker to schedule a phone interview to review the licensing requirements. Correction: The Worker conducted a phone interview with Program Director XXXXX and discussed the licensing rules and regulations.

HAR §17-896-14 — Relay concerns promptly and directly

The Worker was not able to review this rule with the Program Manager. Please contact the Worker to schedule a phone interview to review the licensing requirements. Correction: The Worker conducted a phone interview with Program Director XXXXX and discussed the licensing rules and regulations.

HAR §17-896-13 — No physical punishment or other negative methods of discipline

The Worker was not able to review this rule with the Program Manager. Please contact the Worker to schedule a phone interview to review the licensing requirements. Correction: The Worker conducted a phone interview with Program Director XXXXX and discussed the licensing rules and regulations.

HAR §17-896-12 — Transportation to and from the program shall satisfy all relevant motor carrier safety rules and traffic laws of the state

The Worker was not able to review this rule with the Program Manager. Please contact the Worker to schedule a phone interview to review the licensing requirements. Correction: The Worker conducted a phone interview with Program Director XXXXX and discussed the licensing rules and regulations.

HAR §17-896-6 — Insurance coverage policy

Insurance Coverage Policy is under Statement of Insurance Coverage in the Parent Handbook, pg. 13. Please provide the Worker a copy of the current certificate of liability insurance to meet this requirement. Correction: The Worker received the Certificate of Liability Insurance produced by Atlas Insurance Agency, Inc. covering Le Jardin Academy, Inc. The policy number is XXXXX, which expires on June 30, 2026.

HAR §17-896-6 — Ages of children accepted

The Parent Handbook contains the grade levels accepted in the Extended Day Program, which are Kindergarten through 8th grade (pg. 3). However, the specific ages accepted by the license are not in the Parent Handbook. Please amend the Parent Handbook to include the specific ages accepted by the license for the Extended Day Program. Also, the Worker used the Extended Day Parent Handbook 2023-2024 to review the statement of operation policies which was provided during the previous biennial license review in 2023. Please provide the most current (2025) and updated handbook for review of these policies, which shall include the additional requirements under Hawaii Administrative Rule (HAR) §17-896.1. Correction: The Worker received the Le Jardin Academy Extended Day Parent Handbook SY 2025-2026. It states on page 3: "Students in our Elementary and Middle years must be 5 years old by July 31 before entering and be under 13 years of age."