MONTESSORI COMMUNITY SCHOOL

HAR §17-892.2-3 — Background checks according with chapter 17-801 (criminal history, sex offender registry, child abuse/neglect, adult abuse perpetrator, employment history check, and other information)

Please have the following person submit a completed DHS 948 Annual Background Check Clearance form. --XXXXX expired 9-11-25 -------------------------------------------------------------------------------------------------------------------------------------- Please have the following staff members submit satisfactory employment history covering at least 3 years prior to their date of hire at Montessori Community School (See below for employment history instructions): XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX Employment History Instructions: All employees 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 (EH) form and have the former and/or current employer complete and sign part II. Please complete the following information on the form DHS 959A: the date EH mailed and the date EH returned. Keep copies of all forms mailed out to former employers. If EH forms are not returned after the first try, mail out the form again in a few weeks and log the date of the second mailing. If forms are not returned after the second try, we will accept the written self-certification that two mailed attempts were recorded on the DHS 959A. Forms can be found on our website below: View official inspection document

HAR §17-892.2-55 — Physical exam clearance

Please submit evidence of a satisfactory employment physical examination on a DHS 984 Medical Report Form, taken within 12 months of their date of hire for the following staff members: XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX NOTE: You may obtain the official forms at the following website: View official inspection document

HAR §17-892.2-47 — Admission of children with special needs

Please add a section in your written policies that states whether or not children with special needs are admitted in your facility. If so, your facility needs to adhere to the requirements in this rule section. See HAR §17-892.2-47 Admission of children with special needs for further details

HAR §17-892.2-45 — When over the counter administered, written instructions for use and authorization from parents or guardians on file

Please amend the section in the Handbook page 42 under "Medication" to add the following: "When over the counter administered, written instructions for use and authorization from parents or guardians on file".

HAR §17-892.2-45 — Authorization signed by parents or guardians for administration on file

Please submit a copy of the Medication Release Form

HAR §17-892.2-45 — When prescribed by a physician, medication kept in original container bearing prescription label date filled, directions for use, and child's name

Please amend the section in the Handbook page 42 under "Medication" to add the following: "When prescribed by a physician, medication kept in original container bearing prescription label date filled, directions for use, and child's name"

HAR §17-892.2-35 — Annual health and safety training in at least 2 of the department approved topic areas shall be completed with written evidence provided to the department

Please update the, on-going Health and Safety Training for the following staff: XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX Please submit the required training certificates for the above named staff to PATCH IMMEDIATELY if you haven't already done so. We are reminding you that all caregiving staff need at least 16 hours of department approved training on an ANNUAL basis in at least two topic areas and substitutes need at least 10 hours of training. If they do not complete this requirement, staff may be excluded and these staff members will not be able to count towards the staff-child ratio until they do, which may affect your preschool's ability to meet the required staff child ratio and sequencing requirements.

HAR §17-892.2-35 — All caregivers, substitutes, and volunteers shall complete initial health and safety training within 45 days of hire

Submit an initial Health & Safety Assessment test to PATCH (completed with -0- errors) for: XXXXX XXXXX

HAR §17-892.2-35 — All caregivers meet qualifications

Please have the following staff member register with PATCH Hawaii Early Childhood Registry: XXXXX Please send a copy of her Registry certificate when she receives it.

HAR §17-892.2-18 — Written permission forms from parent or guardians allowing transportation on file

Please submit a copy of your Field Trip permission form.

HAR §17-892.2-11 — Suspension and expulsion of children which includes conditions under which suspension or expulsion shall occur, sufficient time before suspension or expulsion is carried out for parents to secure alternative child care, written notice,

Please submit a written policy regarding Suspension and Expulsion of Children which includes conditions under which suspension or expulsion shall occur, sufficient time before suspension or expulsion is carried out for parents to secure alternative child care, written notice, and records to parents.

HAR §17-892.2-11 — Mandated reporting of suspected child abuse or neglect

Handbook page 38, under "Mandated Reporting Law". Please submit a revised written policy regarding Mandated Reporting to include the Department's contact information: State of Hawaii Department of Human Services (DHS): Oahu: 808-832-5300 (available 24 Hours)

HAR §17-892.2-11 — Grievances, which includes department's information for parents to file complaints

Please submit written policies regarding Grievances and they shall include the Department's contact information in order for families to file a complaint: Child Care Licensing Unit 1 677 Queen Street, Room 400A Honolulu, HI 96812 808-587-5266

HAR §17-892.2-11 — Sanitation practices

Please submit a written policy regarding current sanitation policies/practices for your facility.

HAR §17-892.2-61 — Communications and reunification with families during and after an emergency

Please add a written policy to your Disaster Plan which pertains to Communications and reunification with families during and after an emergency.

HAR §17-892.2-55 — TB clearance

Please submit evidence of a negative TB test result on a DHS 984 Medical Report Form or TB Risk Assessment on a "TB Document F: State of Hawaii TB Clearance Form" taken within 12 months of their date of hire for the following staff members: XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX XXXXX NOTE: You may obtain the official forms at the following website: View official inspection document

HAR §17-892.2-55 — Caregivers with an identified health problem shall provide physician's written statement that they are able to care for children

Please submit a copy of your policy that states that "Caregivers with an identified health problem shall provide physician's written statement that they are able to care for children"

HAR §17-892.2-61 — Sheltering in place at the child care facility

Please submit a written policy that addresses "Sheltering in place at the child care facility"

HAR §17-892.2-61 — Continuity of operations during and after an emergency

Please add a written policy to your Disaster Plan which pertains to Continuity of operations during and after an emergency

HAR §17-892.2-61 — Accommodations of children, including toddlers during an emergency

Please add a written policy to your Disaster Plan which pertains to Providing for the needs of children with disabilities and children with special needs during an emergency.

HAR §17-892.2-61 — Providing for the needs of children with disabilities and children with special needs during an emergency

Please add a written policy to your Disaster Plan which pertains to Providing for the needs of children with disabilities and children with special needs during an emergency.

HAR §17-892.2-61 — Providing for the needs of child with chronic medical conditions during an emergency

Please add a written policy to your Disaster Plan which pertains to Providing for the needs of child with chronic medical conditions during an emergency

HAR §17-892.2-61 — Written evidence of fire warning device or system has been inspected initially and annually and approved by a by fire inspector. Report dated: <date>

Worker received a copy of a Fire Inspection Report dated 10-31-25 with deficiencies. Copy on file. Please submit a copy of a Fire Inspection Report which shows that the current deficiencies have been corrected.

HAR §17-892.2-3 — Annual Background Checks

Please have the following staff members submit completed DHS 948 Authorization for Background Check and to Release Information forms as their clearances have either expired, or will expire within the next 60 days: --XXXXX --XXXXX --XXXXX --XXXXX

HAR §17-892.2-35 — Staff Qualifications

Please have the following staff member submit the proper documentation to The Hawaii DHS Early Childhood Registry with People Attentive to Children (PATCH) so that they can obtain the proper qualifications for the type of staff position occupied: XXXXX