PACT EARLY HEAD START KPT PORTABLES

HAR §17-895.1-96 — Safe Sleep Training

The following has expired safe sleep training: XXXXX - Expired 02/24/2026. XXXXX - Expired 04/08/2026. Additionally, there are new staff that must complete safe sleep training immediately : XXXXX. Please have all caregivers complete safe sleep training immediately. Correction: The Worker verified that all staff's safe sleep training is current.

HAR §17-895.1-3 — Annual Background Clearance

Please have the following complete the DHS 948 Authorization for Background Check and to Release Findings form: XXXXX Please ensure that pages 1 and 2 are fully completed. If any section is not applicable, please put "NA." Please provide the completed DHS 948's immediately. DHS forms can be found at View official inspection document Correction: The Workers received the DHS 948 Authorization for Background Check and to Release Findings forms for the listed staff.

HAR §17-895.1-96 — Safe Sleep Training

Please have staff member XXXXX complete safe sleep training immediately. Note: This deficiency will be satisfied when the Worker is able to verify that PATCH has processed XXXXX safe sleep training. Correction: The Worker verified that all staff have current safe sleep training.

HAR §17-895.1-35 — Health and Safety Training

Staff member XXXXX annual on-going health and safety training period expired on 08/30/2025. According to our records, XXXXX has 6 out of 16 hours of annual training in our system. Please submit the remaining 10 hours of training certificates to People Attentive to Children (PATCH) immediately for processing immediately. Additionally, XXXXX must complete their initial health and safety training assessment immediately. Please have XXXXX complete the initial health and safety training with 100% accuracy and provide the assessment to PATCH for processing. As a reminder, this deficiency will only be satisfied once PATCH has received and credited all training hours in our system. Furthermore, PATCH is taking up to 8 weeks to processing on-going training certificates. Please submit all 16 hours of on-going training certificates to PATCH at least 2 months prior to each staff's expiration date to avoid further deficiencies. Correction: The Worker received the DHS 974A Notification of Changes listing XXXXX termination date. The Worker has verified that XXXXX completed the initial health and safety assessment.

HAR §17-895.1-3 — 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 XXXXX complete the *DHS 948 Authorization for Background Check and to Release Findings form and provide them to the Worker to satisfy this requirement.* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Please also have XXXXX complete and submit the DHS 959 Employment History Clearance and DHS 959A Self-Certification of Employment forms. 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 the DHS 948 Authorization for Background Check and to Release Findings form for XXXXX. The following staff are also due for their annual background clearance and must complete and submit a DHS 948: XXXXX

HAR §17-895.1-11 — Statement of grievance procedures

Complaint/Concern Procedure is in the Family Handbook on page 38. The DHS Licensing Contact Information is provided in the Family Handbook on page 40. Please amend the DHS Licensing Contact Information to include the context for this information, which is for grievances if parents wish to file a complaint to the department after following the program's complaint/concern procedure. Please also include in the classroom the specific office information that is applicable for PACT Early Head Start KPT Portables, which is solely Child Care Licensing Unit 1. Minimally, our office phone number (808) 587-5266 shall be provided to meet this requirement. Correction: The Worker received pictures of the grievance procedure stating "If wishing to file a complaint with the Department of Human Services after following the program's complaint/concern procedure. You may contact: DHS Child Care Licensing Unit 1 at 808-587-5266." The notice is posted on the parent board in both classrooms.

HAR §17-895.1-13 — Information on owner or operator

Please provide the Worker a DHS 953 Statement of Authority to satisfy this requirement. Correction: The Worker received the DHS 953 Statement of Legal Authority with the Board of Directors for 2025.

HAR §17-895.1-35 — All caregivers meet qualifications

Please submit XXXXX qualifications to PATCH Registry to satisfy this requirement. Correction: The Worker verified that XXXXX qualifications were verified by PATCH. XXXXX qualification is Aide qualified.

HAR §17-895.1-35 — Caregivers, substitutes, and volunteers must complete initial health and safety training within 45 days of hire and provide written evidence of completion

Please have XXXXX complete the initial health and safety assessment and submit to PATCH for credit. Correction: The Worker verified that XXXXX has been submitted and processed through PATCH.

HAR §17-895.1-40 — Written evidence of agreement for health consultation (private physician, non-profit health organization, community health consultation service, or health advisory group

Please provide the Worker written evidence of an agreement for health consultation between the facility and a private physician, non-profit health organization, community consultation service, or health advisory group to review the facility's health policies. Correction: The Worker received the health consultation letter.

HAR §17-895.1-96 — All employees, household members and volunteers complete training in safe sleep practices that is approved by the department, upon 30 days of hire or residency, and on an annual basis

Please have XXXXX complete safe sleep training immediately. Correction: The Worker received notice that XXXXX have completed safe sleep training. The Worker verified that it was updated with PATCH.

HAR §17-895.1-55 — Provisions for substitute staff

Please provide the Worker an amended Staff Handbook to include provisions for substitution of staff who are too ill to function effectively or who present a serious health hazard to others at the facility. Correction: The Worker received excerpts from the Staff Handbook with the requested changes.

HAR §17-895.1-55 — Physical exam clearance

Please provide the Worker with the DHS 984 Medical Report and TB clearance for the following staff hired since January 2024: XXXXX. Correction: The Worker received the DHS 984 Medical Reports and TB clearances for XXXXX.

HAR §17-895.1-71 — Written fire inspection report documenting fire warning device inspected initially and annually by a fire inspector report dated: <date>

Please provide the Worker a current satisfactory fire inspection report for the child care facility. Correction: The Worker received a satisfactory Honolulu Fire Department Fire Inspection Report for PACT KPT Portables dated 1/08/2026.

HAR §17-895.1-56 — Written health policies

Please provide the Worker an amended Staff Handbook which includes the written health policies containing the following: (1) Staff with fever, other symptoms of illness, or an altered physical or mental state, shall not be allowed to work. (2) Staff with visible skin conditions, such as lesions, boils, or dermatitis, shall not prepare or serve food or handle utensils and feeding equipment. (3) Staff's appearance shall reflect good grooming habits and personal hygiene, including clean and neat hair and nails, appropriate clothing, and good oral hygiene. (4) No smoking, including electronic smoking devices, is allowed in the presence of the infants and toddlers, nor any parts of the building, which are used for child care, during the hours of operation, and personal nicotine products shall be stored out of reach of children. (5) Alcoholic beverages shall not be consumed prior to and during the hours of operation at the child care facility. If alcoholic beverages are stored at the facility, it shall be locked up and inaccessible to children. (6) Medication that impairs or limits the staff's ability to provide care shall not be consumed prior to or during the hours of child care. (7) Staff shall take appropriate measures to manage stress by maintaining good mental and physical health. Correction: The Worker received excerpts from the Staff Handbook with the requested changes.