HONOLULU WALDORF SCHOOL AFTER SCHOOL CARE

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

We understand that you have submitted a menu to Hawaii Child Care Nutrition Program (HCCNP) for review. Please submit the completed review to the department when you receive approval.

HAR §17-896-16 — Initial and annual health and safety training assessment

All providers shall comply with the new Before and After School Hawaii Administrative Rules (HAR) effective December 31, 2024. Please note the following: HAR §17-896.1-35 (b) Each caregiver, substitutes, and volunteer within forty-five days of hire shall complete their initial (Health & Safety) training. Please submit the initial Health & Safety training assessment to PATCH for XXXXX. Correction: The Worker verified that XXXXX have completed their initial Health and Safety training assessment, which was processed by PATCH.

HAR §17-896-27 — Provisions for substitutes

Please submit a DHS 984 Medical Report form for XXXXX , which shows satisfactory physical exam and TB results. Please visit the following for the required DHS forms: View official inspection document Correction: The Worker received the DHS 984 Medical Report form for XXXXX, which shows a satisfactory physical exam and TB results.

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

Please submit the current Adult and Pediatric First Aid/CPR certificates for the staff members at Honolulu Waldorf School After School Care. Correction: The Worker verified all 4 of the staff members at Honolulu Waldorf School After School Care with their current Adult and Pediatric First Aid/CPR certificates, and that all hours of operation are covered with a staff member that is certified in first aid and child CPR.

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

Please submit a DHS 954 Child Care Center Staff and Volunteer Listing, and DHS 957 Staff Sequence form. Please visit the following for the DHS required form: View official inspection document Correction: The Worker received the DHS 954 Child Care Center Staff and Volunteer Listing, and the DHS 957 Staff Sequence form for Honolulu Waldorf After School Care. Refer to the copies on file.

HAR §17-896-6 — Sanitation practices, grievances, mandated reporting, and suspension/expulsion policies

All providers shall comply with the new Before and After School Hawaii Administrative Rules (HAR) effective December 31, 2024. Please note the following: HAR §17-896.1-11 Statement of Operation Policies (shall be included in the program's statement of operation's policies/ parent handbook) ( 20) Grievances which shall include the department's information for parents to file complaints Child Care Licensing Unit 1 677 Queen Street, Room 400A Honolulu, Hawaii 96813 (808) 587-5266 Please submit your program's updated Parent Handbook, which shall include the new Before and After School rules listed above. Correction: The CCL Worker received the updated parent handbook for Honolulu Waldorf School After School Care, which now contains a grievances section that includes the department's information.

HAR §17-896-27 — Provisions for substitutes

Please submit a DHS 984 Medical Report form for XXXXX, which shows satisfactory physical exam and TB results. Please visit the following for the required DHS forms: View official inspection document Correction: The Worker received the DHS 984 Medical Report form for XXXXX, which shows a satisfactory physical exam and TB results.

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

All providers shall comply with the new Before and After School Hawaii Administrative Rules (HAR) effective December 31, 2024. Please note the following: HAR §17-896.1-61 Disaster Plan for emergencies (a) Written procedures shall address the following: (shall be include in the program's statement of operations policies/parent handbook) (7) Providing for the needs of children with disabilities and children with special needs during an emergency (8) Providing for the needs of children with chronic medical conditions during an emergency Please update your parent handbook or submit documents showing that the above requirements are met. Correction: The Worker received the updated parent handbook for Honolulu Waldorf School After School Care, which now includes the written procedures for providing for the needs of children with disabilities, special needs, and chronic medical conditions during an emergency.

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

Please include in the Parent Handbook the ages of children accepted. Correction: The Worker received the 2025-2026 Parent Handbook for Honolulu Waldorf School, which now includes the ages of children accepted.

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

Please submit a copy of the school's current food establishment inspection report and green pass placard. Correction: During the visit on June 18, 2025, the Worker was informed by the director that food will not be served to the children in care during the Summer Fun Program, as the children are required to provide their own food. As such, a food establishment inspection report and green pass placard are not needed.

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

Please submit the current Adult and Pediatric First Aid/CPR certificates for the staff members at Honolulu Waldorf School After School Care. Correction: The Worker verified 2 of the 9 staff members with their current Adult and Pediatric First Aid/CPR certificates and that all hours of operation are covered with a staff member that is certified in first aid a child CPR. The Head of School informed the Worker that another First Aid/CPR class is scheduled for later in the month of June, so the remaining of their staff members will receive their First Aid/CPR certification.

HAR §17-896-18 — Health consultation provisions

Please provide a written agreement with a physician or public health nurse, who has agreed to be your program's health consultant. Correction: The Worker received a letter from XXXXX, stating that she will serve as the health consultant for Honolulu Waldorf School from August 13, 2025 to July 31, 2026. Refer to the copy on file.

HAR §17-896-16 — Staff training, experience, and personal qualifications

Please submit a DHS 954 Child Care Center Staff and Volunteer Listing. Once we receive the DHS 954, we will verify if each staff member meets the qualifications for their listed role. Please visit the following for the DHS required form: View official inspection document Correction: The Worker received a current DHS 954 Child Care Staff and Volunteer Listing from the Head of School, and verified that each staff member at Honolulu Waldorf School After School Care has the proper qualifications to fulfill their listed role.

HAR §17-896-13 — 25% gross motor activities to promote physical development

Please submit a daily schedule of the Summer Fun program's activities, which indicates that twenty-five percent of the program time is spent in gross motor activities to promote physical activities. Correction: The Worker received the daily schedule of activities for Honolulu Waldorf School Summer Fun program of activities from the Head of School. The Worker verified that 25% of each day consists of gross motor activities. Refer to the copy on file.

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

Please submit a copy of your Summer Fun program's daily schedule of activities, and menu of the snacks served. Correction: The Worker received the Honolulu Waldorf School Summer Fun program of activities. A menu of the snacks served was not received, as the Head of School informed the Worker that snacks are not served in the Summer Fun program, and the children are to bring their own snacks.

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

Please submit the admission forms that that require sufficient information and instruction to be received from parents or guardians that enable caregiver to care for the child, which includes the following information: 1.) Child name, DOB, address; 2.) Parent/guardian name and address; 3.) Parent/guardian contact information; 4.) Name, address and phone numbers of person to assume responsibility when parents/guardians are not available; and 5.) Name address and phone numbers of person authorized to take child from facility Correction: During the visit on June 18, 2025, the Worker verified that the Honolulu Waldorf School Summer Fun Registration form contains the sufficient information and instruction to be received by the parents/guardians that enable the caregiver to care for each child. Refer to the copy on file.

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

Please submit a DHS 954 Child Care Center Staff and Volunteer Listing. Please visit the following for the DHS required form: View official inspection document Correction: The Worker received the DHS 954 Child Care Staff and Volunteer Listing from the Head of School. Refer to the copy on file.

HAR §17-896-6 — Insurance coverage policy

Please include in the Parent Handbook a statement informing the parents/guardians the program's liability insurance coverage. Correction: The Worker received the 2025-2026 Parent Handbook for Honolulu Waldorf School, which now includes a statement that informs the parents/guardians about the program's liability insurance coverage.

HAR §17-896-6 — Maximum number of children permitted by license

Please include in the Parent Handbook the maximum number of children permitted by license. Correction: The Worker received the 2025-2026 Parent Handbook for Honolulu Waldorf School, which now includes the maximum number of children permitted by license.

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

Please schedule a fingerprinting appointment with the department immediately for staff member XXXXX. We've attached a DHS 948 Authorization for Background Check and to Release Information for your use. Also, please see the attached DHS 961A for instructions. Correction: XXXXX has been fingerprinted by the department, and her child abuse/neglect check results have been satisfactorily cleared.

HAR §17-896-3 — Employment history check

Please submit the employment history check clearances (DHS 959 Employment History Form and DHS 959A Self-Certification of Employment form) for the following new staff members for the last three (3) years from their date of hire: 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 the satisfactory DHS 959A Self-Certification of Employment and DHS 959 Employment History Clearance forms for XXXXX.

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

Child Care Licensing (CCL) Worker conducted a telephone licensing desk review with the director for Honolulu Waldorf School After School Care. The Worker discussed the Hawaii Administrative Rules and pertinent documents that are still required to be submitted with the director. An observation of the children in care and the child care areas are still required, as the program is slated to open their Summer Fun program on June 9, 2025. Correction: The Worker conducted an unannounced drop-in visit to Honolulu Waldorf School After School Care to observe the children in care, verify that the staff-child ratio is being met, inspect the child care areas, and collect pertinent documents. The program utilizes one classroom in Honolulu Waldorf School, and an outdoor play area with multiple play structures. During the visit, the Worker observed the children placed in one group, as they were in outdoor play time and snack time. There are currently 20 children enrolled in the program, with 19 children in attendance at the time of the visit.

HAR §17-896-3 — Criminal history check

Please schedule a fingerprinting appointment with the department for staff member XXXXX. Please visit the following for the required DHS form: View official inspection document Correction: XXXXX has been fingerprinted by the department, and her criminal history check results have been satisfactorily cleared.