HANAHAUOLI SCHOOL AFTER SCHOOL CARE

HAR §17-896.1-17 — List of staff members and position

Please provide a DHS 954 Staff and Volunteer Listing. Forms can be found on our website below: View official inspection document

HAR §17-896.1-3 — Inspection of facility, activities, records, staff

During the visit, the Workers briefly met with the Director of Auxiliary Programs, XXXXX. However, the Workers were unable to discuss the licensing rules with the Director due to time constraints. Worker will need to return to review the licensing rules. Correction: The Worker conducted a phone interview with XXXXX and reviewed the licensing rules.

HAR §17-896.1-3 — Background checks according with chapter 17-801 (criminal history, sex offender registry, child abuse/neglect, adult abuse perpetrator, employment history check, and other information)

1. The following staff have expired or soon-to-be expiring annual background checks: XXXXX Please have these individuals complete a DHS 948 Authorization for Background Check and to Release Findings form IMMEDIATELY and return the completed copies to the Worker for processing. 2. You have also listed individuals on the DHS 957 Staff Sequence Form who are not currently associated with the After School Care. Please schedule the following for an initial fingerprint at a Department of Human Services office IMMEDIATELY : XXXXX. 3. Additionally, please submit completed employment history for staff members XXXXX , which includes the DHS 959 Employment History and DHS 959A Self-Certification of Employment forms. Please note that the DHS 959A submitted for XXXXX on 3/17/26 were not considered complete due to lack of a 2nd mailed attempt date. 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 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 §17-896.1-11 — Ages of children accepted

§17-896.1-11 Statement of operation policies states that the facility shall have written operation policies, which shall be available to the department, caregiver staff, and parents or guardians to the children for whom care is, or may be, available. Please provide a current parent handbook to the Worker.

HAR §17-896.1-12 — Evidence of liability coverage

Please provide the program's Certificate of Liability Insurance to the Worker.

HAR §17-896.1-14 — Written notification of changes in staff member who provide direct care to children provided to the department within five working days after the change

Please provide a DHS 974A Notification of Changes form with the following information: 1. When XXXXX was hired for the After School Care. 2. When XXXXX was hired for the After School Care. Forms can be found on our website below: View official inspection document

HAR §17-896.1-15 — Name, address and phone numbers of person to assume responsibility when parents/guardians are not available

Please provide the Worker additional or amended enrollment forms demonstrating that the facility is collecting the name, address, and phone numbers of persons to assume responsibility when a child's parent/guardian is unavailable.

HAR §17-896.1-15 — Name, address and phone numbers of person authorized to take child from facility

Please provide the Worker additional or amended enrollment forms demonstrating that the facility is collecting the name, address, and phone numbers of persons who are authorized by the child's parent/guardian to take their child away from the facilty.

HAR §17-896.1-17 — Roster/attendance records

During the visit, the Worker observed staff having a clipboard with their group of assigned children. The clipboard contains the enrolled children's names and time checked in to the program, as well as notes of children who are signed up for in-school extracurricular activities, in which those children may check in late or check in and out of the After School Care. However, the staff members do not actively notate when the child has checked out. Instead, there is a staff member at the front of the school with a roster of the total enrollment who notates the children that are picked up. Please amend the attendance record keeping system to ensure that the assigned staff are actively collecting both the sign-in and sign-out times for the children in their group.

HAR §17-896.1-61 — Evacuation

Please provide the program's written disaster plan to cover emergencies such as fire, flood, tsunami, hurricane/tropical storm, and earthquake. The plan must also include written procedures for: 1. Evacuation; 2. Relocation; 3. Sheltering-in-place; 4. Lock-down; 5. Communication and reunification with families during and after an emergency; 6. Continuity of operations during and after an emergency; 7. Providing for the needs of children with disabilities and children with special needs during an emergency; and 8. Providing for the needs of children with chronic medical conditions during an emergency.

HAR §17-896.1-17 — Log of emergency preparedness drills

Please provide a log of emergency preparedness drills conducted during the After School Care.

HAR §17-896.1-35 — Caregivers qualified for the age group with which they work

Please provide the following staff members resumes so that we can determine if they are program leader qualified: XXXXX

HAR §17-896.1-35 — All caregivers, substitutes, and volunteers shall complete initial health and safety training within 45 days of hire

1. The following must complete the basic initial health and safety assessment immediately: XXXXX As a reminder, all new staff members must complete the basic initial health and safety assessment within 45 days of their hire date. Please have new hires complete the assessment with 100% accuracy and submit to People Attentive to Children (PATCH) immediately to avoid delay in processing time. 2. Additionally, the DHS 957 Staff Sequence form you submitted lists individuals who are not associated with the After School Care.

HAR §17-896.1-35 — Caregivers shall complete at least 16 hours of ongoing training in at least 2 of the department approved topic areas

The following staff have deficient annual health and safety training. Please have the following complete all 16 hours of on-going health and safety training and submit their certificates to PATCH immediately: XXXXX - Has 0 out of 16 hours. Training period expired 12/27/2025. XXXXX - Has 0 out of 16 hours. Training period expired 12/27/2025. XXXXX - Has 0 out of 16 hours. Training period expired 12/27/2025. XXXXX - Has 0 out of 16 hours. Training period expired 2/18/2026. XXXXX - Has 0 out of 16 hours. Training period expired 2/13/2026. XXXXX - Has 0 out of 16 hours. Training period expired 2/13/2026. XXXXX - Has 0 out of 16 hours. Training period expired 3/23/2026.

HAR §17-896.1-36 — Staff-child ratio shall be met and maintained at all times

Hanahau'oli School After School Care is licensed for 90 children, ages over 4 years 8 months to under 13 years of age. During the visit, the Workers observed the following groups of children and which did not meet staff-child ratio: Pavilion: 15 children with 1 program leader. XXXXX Outdoor play area: 35 children with 1 program leader and 3 aides. XXXXX Staff-child ratio was not met in the outdoor play group as a minimum of 2 program leaders are required. Although in the DHS 957 Staff Sequence Form XXXXX were listed as program leaders, their resumes were not provided to the Worker to verify that those individuals meet qualifications. To correct this deficiency, please provide their resumes to the Worker.

HAR §17-896.1-40 — Written evidence that an arrangement has been made with a health care professional to provide consultation

All programs shall have on file written evidence that an arrangement has been made with a health care professional to provide consultation. Please provide a health consultation agreement letter to the Worker.

HAR §17-896.1-42 — Written permission from parent/guardian for child to receive emergency care

Every child care facility shall have the following in writing: 1. The name, address, and telephone number of a physician or health resource that shall be called in case of emergency; or 2. The name of the nearest hospital or clinic where such care may be provided; and 3. Permission of the parent or guardian to call the stated physician or health resource, or the hospital or clinic, if the parent/guardian cannot be reached in the case of a health emergency. Please provide the form in which the program is collecting the child's physician/health resource or hospital/clinic information, as well as the authorization form allowing the program to contact that physician/health resource or the hospital/clinic.

HAR §17-896.1-55 — TB clearance

Please provide a completed TB clearance for the following: XXXXX Note: Must be dated within 1 year from hire.

HAR §17-896.1-55 — Physical exam clearance

Please provide a completed DHS 984 Medical Report for the following: XXXXX Note: Must be dated within 1 year from hire. Forms can be found on our website below: View official inspection document

HAR §17-896.1-47 — Biennial nutrition review dated: <date>

Please provide a nutrition review for the PM snacks served.

HAR §17-896.1-56 — Written health policies for staff for personal health care and control for the spread of communicable diseases

Please provide a current staff handbook, which should include: 1. Provisions for substitutes when staff are ill; 2. Personal health care; 3. Control for the spread of communicable diseases; 4. Smoking; 5. Alcohol; 6. Medication which may impair the staff member's ability to care for children; 7. Accident prevention; and 8. Procedures for infection control to prevent transmission of blood-born germs.

HAR §17-896.1-43 — One caregiver with current pediatric first aid certificate and child CPR during operating hours

Please provide all available staff's pediatric first aid and child CPR certificate to the Worker. Please also provide the DHS 957 Staff Sequence form, as well as the DHS 954 Staff and Volunteer Listing, to demonstrate that all hours of child care are covered by at least one (1) staff member with department-approved certification. Note: The Worker received the DHS 957 Staff Sequence Form submitted on 3/17/26; however, it lists all staff and all children. Please create new copies with the staff organized by the group of children they are assigned to. Forms can be found on our website below: View official inspection document

HAR §17-896-3 — Criminal history check

The criminal history clearance for XXXXX is expired. In addition, the clearance for XXXXX will be expiring soon. Please submit a completed DHS 948 Authorization for Background Check and to Release Findings form for the above mentioned staff member immediately. *Note: please use the new DHS 948 Authorization for Background Check and to Release Findings form with the date of 06/2024. See attached * Correction: The Worker received the DHS 948 clearance form for XXXXX, and a DHS 974A Notification of Changes form which states that XXXXX is no longer employed in the program.

HAR §17-896-3 — Child care abuse/neglect check

The child abuse/neglect clearance for XXXXX is expired. In addition, the clearance for XXXXX will be expiring soon. Please submit a completed DHS 948 Authorization for Background Check and to Release Findings form for the above mentioned staff members immediately. *Note: please use the new DHS 948 Authorization for Background Check and to Release Findings form with the date of 06/2024. See attached * Correction: The Worker received the DHS 948 clearance form for XXXXX, and a DHS 974A Notification of Changes form which states that XXXXX is no longer employed in the program.

HAR §17-896-3 — Criminal history check

The criminal history clearances for XXXXX will be expiring soon. Please submit a completed DHS 948 Authorization for Background Check and to Release Findings for XXXXX immediately. *Note: please use the new DHS 948 form with the date of 06/2024. See attached * Correction: The Worker received the DHS 948 Authorization for Background Check and to Release Findings form for XXXXX.